Organization Name: | SAWTOOTH PHYSICAL THERAPY |
NPI Number: | 1013206002 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RONALD D MILLER (PRESIDENT) |
Mailing Address: | 7979 W Rifleman St Boise |
State: | ID US |
Postal Code: | 837049066 |
Phone Number: | 2083405099 |
Fax Number: | |
NPI Enumeration Date: | 03/31/2011 |
NPI Last Update Date: | 09/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | PT 1938 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |