Organization Name: | EAGLE ORTHOPEDIC & SPORTS PHYSICAL THERAPY, PLLC |
NPI Number: | 1952425464 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRISTINE M. LUNDBERG (PHYSICAL THERAPIST/OWNER) |
Mailing Address: | 600 Valley Centre Drive Driggs |
State: | ID US |
Postal Code: | 83422 |
Phone Number: | 2083540089 |
Fax Number: | 5095610536 |
NPI Enumeration Date: | 03/19/2007 |
NPI Last Update Date: | 03/06/2015 |
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 |