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General NPI Number Information
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NPI Number | 1356020150
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Entity Type | Organization
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Legal Business Name | ALPENGLOW PHYSIO LLC
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Dates
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Enumeration Date | 07/18/2023
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Last Update Date | 07/18/2023
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Provider Practice Location Address
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Address Line | 111 S CENTER ST
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City | SALMON
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State | ID
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Zip | 83467-4252
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Country | US
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Telephone | 617-620-5534
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Fax |
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Provider Business Mailing Address
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Address Line | 607 FULTON ST
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City | SALMON
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State | ID
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Zip | 83467-3718
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, PHYSICAL THERAPIST
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Name | DR. LORI KOHLS
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Credential | DPT
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Telephone | 617-620-5534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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