MEDICARE: ALPINE PHYSICAL THERAPY CENTER, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist		ID

General Provider Information

NPI Number	:	1528143450
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPINE PHYSICAL THERAPY CENTER, P.C.

Provider Business Mailing Address
First Line	:	PO BOX 3115
Second Line	:
City	:	HAYDEN
State	:	ID
Zip	:	83835-3115
Country	:	US
Telephone Number	:	208-762-0881
Fax Number	:	208-762-5961

Provider Business Practice Location Address
First Line	:	31911 N 5TH AVE
Second Line	:
City	:	SPIRIT LAKE
State	:	ID
Zip	:	83869
Country	:	US
Telephone Number	:	208-623-6717
Fax Number	:	208-623-4898

Authorized Official
Title or Position	:	PRESIDENT/PHYSICAL THERAPIST
Name	:	GARY D SCHNEIDER
Credential	:
Telephone Number	:	208-762-0881

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	08/23/2024

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