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General NPI Number Information
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NPI Number | 1518478734
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Entity Type | Organization
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Legal Business Name | CURRENT PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 10/15/2017
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Last Update Date | 11/10/2017
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Provider Practice Location Address
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Address Line | 441 S WHITLEY DR
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City | FRUITLAND
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State | ID
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Zip | 83619-2542
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Country | US
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Telephone | 208-452-7197
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Fax | 208-452-4811
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Provider Business Mailing Address
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Address Line | 441 S WHITLEY DR
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City | FRUITLAND
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State | ID
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Zip | 83619-2542
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Country | US
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Telephone | 208-452-7197
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Fax | 208-452-4811
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Authorized Official
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Title or Position | PROVIDER, OWNER
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Name | NICHOLAS HARTLEY
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Credential | DPT
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Telephone | 541-212-0037
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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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