Healthcare Provider Details

I. General information

NPI: 1215576640
Provider Name (Legal Business Name): INLAND PELVIC HEALTH & PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2020
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8382 N WAYNE DR STE 204
HAYDEN ID
83835-6028
US

IV. Provider business mailing address

8382 N WAYNE DR STE 101
HAYDEN ID
83835-6028
US

V. Phone/Fax

Practice location:
  • Phone: 208-719-9071
  • Fax: 208-719-9073
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: LAURA STEININGER
Title or Position: OWNER; PHYSICAL THERAPIST
Credential: DPT
Phone: 208-719-9071