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General NPI Number Information
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NPI Number | 1063218444
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Entity Type | Organization
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Legal Business Name | SELKIRK PHYSICAL THERAPY, PC
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 606 N FIFTH AVE
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City | SANDPOINT
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State | ID
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Zip | 83864-1520
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Country | US
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Telephone | 208-297-1570
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Fax | 208-593-3097
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Provider Business Mailing Address
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Address Line | 483 WOODLAND DR
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City | SANDPOINT
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State | ID
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Zip | 83864-7211
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Country | US
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Telephone | 815-980-0269
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Fax | 208-593-3097
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Authorized Official
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Title or Position | OWNER
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Name | KENNETH G FISCHER
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Credential | DPT
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Telephone | 208-297-1570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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