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General NPI Number Information
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NPI Number | 1477193795
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Entity Type | Organization
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Legal Business Name | ZONA PHYSICAL THERAPY
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Dates
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Enumeration Date | 01/15/2020
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Last Update Date | 01/15/2020
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Provider Practice Location Address
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Address Line | 11483 W FAIRVIEW AVE
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City | BOISE
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State | ID
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Zip | 83713-7940
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Country | US
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Telephone | 208-740-3232
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Fax |
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Provider Business Mailing Address
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Address Line | 4181 RANGEWOOD WAY
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City | MERIDIAN
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State | ID
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Zip | 83642-5065
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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 | COO
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Name | DR. TYLER BURTON
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Credential |
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Telephone | 661-916-3442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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