Organization
SPINE AND SPORT PYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODY BOYD RAWLINGS P.T. (PHYSICAL THERAPIST)
(208) 359-6127
Entity
Organization
Contact information
Practice address
217 N 2ND EAST, REXBURG, ID 83440-1621
(208) 359-6127
(208) 359-9479
Mailing address
217 N 2ND EAST, REXBURG, ID 83440-2057
(208) 359-6127
(208) 359-9479
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1346
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010020600
REGENCE BLUE SHIELD
ID
01
—
185556100
US DEPARTMENT OF LABOR
—
01
—
650015362
RAILROAD MEDICARE
—
05
—
805399800
—
ID
01
—
T3860
BLUE CROSS
ID
Enumeration date
03/06/2008
Last updated
12/18/2025
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