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General NPI Number Information
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NPI Number | 1679520191
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Entity Type | Organization
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Legal Business Name | ACTION THERAPY, P.C.
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Dates
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Enumeration Date | 05/29/2006
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Last Update Date | 08/12/2010
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Provider Practice Location Address
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Address Line | 3090 GENTRY WAY #250
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City | MERIDIAN
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State | ID
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Zip | 83642
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Country | US
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Telephone | 208-888-0044
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Fax | 208-888-2211
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Provider Business Mailing Address
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Address Line | 3090 GENTRY WAY #250
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City | MERIDIAN
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State | ID
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Zip | 83642
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Country | US
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Telephone | 208-888-0044
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Fax | 208-888-2211
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DAVID S RAY
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Credential | PT
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Telephone | 208-888-0044
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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 | ID
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Taxonomy #2
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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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