Idaho Physical Medicine and Rehabilitation PA

NPI #1497949705 in Meridian, Idaho

Provider Information

NPI Number: 1497949705
Entity Type: Organization
Organization Name: Idaho Physical Medicine and Rehabilitation PA
Subpart: Yes (part of a larger organization)
Parent Organization: IDAHO PHYSICIAL MEDICINE AND REHABILITATION
Primary Specialty: Clinic/Center - Ambulatory Surgical
Enumeration Date: Aug 29, 2007
Last Updated: Jun 5, 2014

Practice Location

Address: 3551 E OVERLAND ROAD
City: Meridian
State: Idaho
ZIP Code: 83642
Phone: (208) 884-1333

Authorized Official

Name: KATE A SHELTON
Title: ADMINISTRATOR
Phone: (208) 287-6558

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Medicine & Rehabilitation - Pain Medicine — Pain Medicine	2081P2900X
Clinic/Center - Ambulatory Surgical — Ambulatory Surgical	261QA1903X	Primary

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