| Organization Name: | PREFERRED PHYSICAL THERAPY, P.A. |
| NPI Number: | 1447389093 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEREMY THOMAS PETTINGER (PRESIDENT) |
| Mailing Address: | 126 E Main St Grangeville |
| State: | ID US |
| Postal Code: | 835302211 |
| Phone Number: | 2084065195 |
| Fax Number: | 2089830114 |
| NPI Enumeration Date: | 03/02/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |