Timber Ridge Industrial Therapy, PLLC
Clinic/Center, Physical Therapy in Coeur D'Alene, ID. Organization (NPI-2).
NPI number1346876166
StatusActive
Last updated in NPPESApr 4, 2020
Details
- NPI
- 1346876166
- Entity type
- Organization (NPI-2)
- Legal business name
- Timber Ridge Industrial Therapy, PLLC
- Organization subpart
- No
- Enumeration date
- Mar 13, 2020
- Certification date
- Apr 4, 2020
- Last updated
- Apr 4, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2000X | Clinic/Center, Physical Therapy | – | – | Yes |
Practice location
610 Hubbard Ave Ste 226Coeur D'Alene, ID 83814
Phone 208-818-7404
Mailing address
31200 N Red Fir RdAthol, ID 83801-3100
Fax 208-567-9508
Authorized official
Christopher A Stoddard
Owner
2088187404
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