Boost Ventures PLLC
Physical Therapist in Rexburg, ID. Organization (NPI-2).
NPI number1740883172
StatusActive
Last updated in NPPESNov 18, 2020
Details
- NPI
- 1740883172
- Entity type
- Organization (NPI-2)
- Legal business name
- Boost Ventures PLLC
- Organization subpart
- No
- Enumeration date
- Nov 18, 2020
- Certification date
- Nov 18, 2020
- Last updated
- Nov 18, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
Other names
- Boost Physical Therapy (Doing Business As)
Practice location
36 N 2nd WRexburg, ID 83440-1515
Phone 208-313-7569
Mailing address
36 N 2nd WRexburg, ID 83440-1515
Phone 208-313-7569
Authorized official
Blake Galbraith
Owner
2083137569
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