Primary Therapy Source, LLC

NPI #1912027343 in Twin Falls, Idaho

Provider Information

NPI Number: 1912027343
Entity Type: Organization
Organization Name: Primary Therapy Source, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Mar 30, 2007
Last Updated: Nov 7, 2007

Practice Location

Address: 254 RIVER VISTA PL
City: Twin Falls
State: Idaho
ZIP Code: 83301
Phone: (208) 734-7333

Authorized Official

Name: DEBORAH JAN YINGST, PT
Title: OWNER
Phone: (208) 734-7333

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X
Speech-Language Pathologist	235Z00000X
Physical Therapist	225100000X	Primary

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