Pocatello Physical Therapy Clinic PA

NPI #1184707911 in Pocatello, Idaho

Provider Information

NPI Number: 1184707911
Entity Type: Organization
Organization Name: Pocatello Physical Therapy Clinic PA
Primary Specialty: Physical Therapist
Enumeration Date: Oct 23, 2006
Last Updated: May 10, 2011

Practice Location

Address: 1033 W QUINN RD
City: Pocatello
State: Idaho
ZIP Code: 83202-2425
Phone: (208) 233-4800

Authorized Official

Name: DAN R DES FOSSES, PT
Title: PRESIDENT OWNER
Phone: (208) 233-4800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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