| Organization Name: | EAGLE PHYSICAL THERAPY PA |
| NPI Number: | 1750478327 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RANDALL K LANGLEY (OWNER) |
| Mailing Address: | 457 S Fitness Pl Suite 100 Eagle |
| State: | ID US |
| Postal Code: | 836166568 |
| Phone Number: | 2089393332 |
| Fax Number: | 2089393338 |
| NPI Enumeration Date: | 10/06/2006 |
| NPI Last Update Date: | 09/01/2009 |
| 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 |