| Organization Name: | KOTH SPORTS PHYSICAL THERAPY, PA |
| NPI Number: | 1265524045 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHERRI L KOTH (ITS SECRETARY/TREASURER, ITS BUS MG) |
| Mailing Address: | 101 Saddle Road Ketchum |
| State: | ID US |
| Postal Code: | 833401510 |
| Phone Number: | 2087269222 |
| Fax Number: | 2087261607 |
| NPI Enumeration Date: | 09/29/2006 |
| NPI Last Update Date: | 01/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |