| Organization Name: | SUN VALLEY SPORTS REHABILITATION |
| NPI Number: | 1639229115 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | COLLEEN COYNE (PRESIDENT, OWNER) |
| Mailing Address: | 245 Raven Rd Ketchum |
| State: | ID US |
| Postal Code: | 83340 |
| Phone Number: | 2087267246 |
| Fax Number: | 2087268911 |
| NPI Enumeration Date: | 01/10/2007 |
| NPI Last Update Date: | 06/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251S0007X |
| License Number: | PT-332 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Sports |
| Taxonomy Definition: | |