Organization Name: | PHYSIOONE |
NPI Number: | 1659642775 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TYLER BLACKWELDER (OWNER) |
Mailing Address: | 8382 N Wayne Dr Hayden |
State: | ID US |
Postal Code: | 838356028 |
Phone Number: | 2088189263 |
Fax Number: | |
NPI Enumeration Date: | 01/20/2012 |
NPI Last Update Date: | 10/17/2012 |
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 |