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General NPI Number Information
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NPI Number | 1548196587
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Entity Type | Organization
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Legal Business Name | PICK PT NAMPA PHYSICAL THERAPY
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Dates
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Enumeration Date | 06/18/2026
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Last Update Date | 06/18/2026
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Provider Practice Location Address
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Address Line | 2422 12TH AVE RD
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City | NAMPA
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State | ID
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Zip | 83686-6300
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Country | US
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Telephone | 208-466-0566
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Fax | 208-697-5213
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Provider Business Mailing Address
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Address Line | 2422 12TH AVE RD
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City | NAMPA
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State | ID
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Zip | 83686-6300
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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 | CREDENTIALING
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Name | MACKENZIE JACOBSON
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Credential |
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Telephone | 509-690-0859
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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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