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General NPI Number Information
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NPI Number | 1316590813
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Entity Type | Organization
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Legal Business Name | FIT & FUNCTION THERAPY SOLUTIONS, LLC
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Dates
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Enumeration Date | 07/23/2019
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Last Update Date | 07/23/2019
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Provider Practice Location Address
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Address Line | 2273 S VISTA AVE STE 120
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City | BOISE
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State | ID
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Zip | 83705-7350
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Country | US
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Telephone | 208-297-3271
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Fax |
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Provider Business Mailing Address
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Address Line | 1418 S WILCOMB ST
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City | BOISE
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State | ID
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Zip | 83705-2356
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Country | US
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Telephone | 503-575-6811
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | TRISHA OSTRANDER
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Credential | OTD, CHT
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Telephone | 503-575-6811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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