Primary Therapy Source LLC

NPI #1235385659 in Twin Falls, Idaho

Provider Information

NPI Number
1235385659
Entity Type
Organization
Organization Name
Primary Therapy Source LLC
Subpart
Yes (part of a larger organization)
Parent Organization
PRIMARY THERAPY SOURCE LLC
Primary Specialty
Occupational Therapist
Enumeration Date
Aug 18, 2008
Last Updated
Aug 18, 2008

Practice Location

Address
254 RIVER VISTA PL
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
Occupational Therapist

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