DYNAMIC PHYSICAL THERAPY PLLC NPI 1619360245

NPI Information

NPI: 1619360245
Provider Name: DYNAMIC PHYSICAL THERAPY PLLC
Classification: Clinic/Center - 261QR0401X
Entity Type: Organization

Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)

Address:
1023 21ST ST
LEWISTON, ID
ZIP 83501
Phone: (208) 743-1795
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DYNAMIC PHYSICAL THERAPY PLLC is a rehabilitation and comprehensive outpatient rehabilitation facility (corf) clinic center in Lewiston, ID. DYNAMIC PHYSICAL THERAPY PLLC NPI is 1619360245. The provider is registered as an organization entity type.

The provider's business location address is:

1023 21ST ST
LEWISTON, ID
ZIP 83501-415
Phone: (208) 743-1795
Fax: (208) 743-1791

The provider's authorized official is Johanna M Strehle .
The authorized official title is Physical Therapist and has the following contact phone number (208) 743-1795.

The enumeration date for this NPI number is 3/6/2015 and was last updated on 12/21/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0401X	Clinic/Center	Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)	PT-1861	IDAHO	Yes

What is NPI?

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This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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