Healthcare Provider Details

I. General information

NPI: 1376480392
Provider Name (Legal Business Name): VALLEY IN MOTION PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3863 WOOD RD
VICTOR ID
83455-5352
US

IV. Provider business mailing address

PO BOX 303
DRIGGS ID
83422-0303
US

V. Phone/Fax

Practice location:
  • Phone: 208-295-2545
  • Fax:
Mailing address:
  • Phone: 208-295-2545
  • 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: MARGARET BENNETT
Title or Position: OWNER
Credential: PT, DPT
Phone: 845-667-9468