Eagle Physical Therapy PA

NPI #1750478327 in Eagle, Idaho

Provider Information

NPI Number: 1750478327
Entity Type: Organization
Organization Name: Eagle Physical Therapy PA
Primary Specialty: Physical Therapist
Enumeration Date: Oct 6, 2006
Last Updated: Sep 1, 2009

Practice Location

Address: 457 S FITNESS PL
Address 2: SUITE 100
City: Eagle
State: Idaho
ZIP Code: 83616-6568
Phone: (208) 939-3332

Authorized Official

Name: MR. RANDALL K LANGLEY, MPT, OCS
Title: OWNER
Phone: (208) 939-3332

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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