Physical Therapy 180

LBN: Physical Therapy 180 Llc
Physical Therapy 180 is an health care organization with primary practice located at 5909 W State Street , Boise ID 83703. The organization recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as the primary health care specialty. Physical Therapy 180 Llc can be contacted via phone (208) 343-7700, or through Mcknight, Cory Allen via phone (208) 343-7700.

Contact Information

Primary practice address
5909 W State Street Boise ID 83703
Phone: (208) 343-7700
Fax: (208) 331-2591
Website:
Map and Directions
Authorized official contact:
Name: Mcknight, Cory Allen
Phone: (208) 343-7700

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X

Profile Details

NPI number 1669696910
LBN Legal business name Physical Therapy 180 Llc
DBA Doing business as Physical Therapy 180
Authorized official Mcknight, Cory Allen
Entity Organization
Organization subpart 1 No
Enumeration date Apr 11th, 2007
Last updated Jan 17th, 2019 - about 5 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 1669696910 NPPES
Idaho MEDICAID 808631800

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