Primary Therapy Source LLC
NPI #1114170024 in Twin Falls, Idaho
Provider Information
- NPI Number
- 1114170024
- Entity Type
- Organization
- Organization Name
- Primary Therapy Source LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- PRIMARY THERAPY SOURCE LLC
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- Oct 23, 2008
- Last Updated
- Oct 23, 2008
Practice Location
- Address
- 254 RIVER VISTA PL
- City
- Twin Falls
- State
- Idaho
- ZIP Code
- 83301-3006
- Phone
- (208) 734-7333
Authorized Official
- Name
- JAN YINGST, PT
- Title
- OWNER
- Phone
- (208) 734-7333
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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