Gridiron Rehab And Athletic Fitness, Llc

LBN: Gridiron Rehab And Athletic Fitness, Llc
Gridiron Rehab And Athletic Fitness, Llc is an health care organization with primary practice located at 3035 W Mcmillan Rd Suite 104, Meridian ID 83646. The organization recently has only one registered license in Ambulatory Health Care Facilities / Physical Therapy, which is considered as the primary health care specialty. Gridiron Rehab And Athletic Fitness, Llc can be contacted via phone (208) 887-8684, or through Tamura, Eric via phone (208) 887-8684.

Contact Information

Primary practice address
3035 W Mcmillan Rd Suite 104 Meridian ID 83646
Phone: (208) 887-8684
Fax: (208) 887-9226
Website:
Map and Directions
Authorized official contact:
Name: Tamura, Eric
Phone: (208) 887-8684

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Physical Therapy 261QP2000X

Profile Details

NPI number 1033359450
LBN Legal business name Gridiron Rehab And Athletic Fitness, Llc
DBA Doing business as
Authorized official Tamura, Eric
Entity Organization
Organization subpart 1 No
Enumeration date Feb 25th, 2009
Last updated May 17th, 2018 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033359450 NPPES
Idaho MEDICAID 808389100
Idaho Other T9390

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