Pocatello Physical Therapy Clinic Pa
LBN: Pocatello Physical Therapy Clinic Pa
Pocatello Physical Therapy Clinic Pa is an health care organization with primary practice located at 1033 W Quinn Rd , Pocatello ID 83202-2425. 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.
Pocatello Physical Therapy Clinic Pa can be contacted via phone (208) 233-4800, or through Des Fosses, Dan R via phone (208) 233-4800.
Contact Information
Primary practice address
1033 W Quinn Rd
Pocatello ID 83202-2425
Phone: (208) 233-4800
Fax: (208) 233-4887
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | Idaho |
Profile Details
| NPI number | 1184707911 |
|---|---|
| LBN Legal business name | Pocatello Physical Therapy Clinic Pa |
| DBA Doing business as | |
| Authorized official | Des Fosses, Dan R Physical Therapist (PT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 23rd, 2006 |
| Last updated | May 10th, 2011 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184707911 | NPPES |
| Idaho | MEDICAID | 002463600 | |
| Idaho | Other | 000010026861 | |
| Idaho | Other | T0296 |
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