| 208 Physical Therapy Llc | |
|
1120 Stocks Ave Ste C, Rexburg, ID 83440-3590 | |
| (208) 261-2123 | |
| Not Available |
| Full Name | 208 Physical Therapy Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist - Orthopedic |
| Location | 1120 Stocks Ave Ste C, Rexburg, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851016356 | NPI | - | NPPES |
| 1477045581 | Other | ID | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2251X0800X | Physical Therapist - Orthopedic | (* (Not Available)) | Primary |
| Provider Name | Tyrel J Nelson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1477045581 PECOS PAC ID: 9133478647 Enrollment ID: I20180816001758 |
| Mailing Address | Practice Location Address |
|---|---|
| 208 Physical Therapy Llc 1940 S Bonito Way Ste 190, Meridian, ID 83642-5618 Ph: (208) 287-9420 | 208 Physical Therapy Llc 1120 Stocks Ave Ste C, Rexburg, ID 83440-3590 Ph: (208) 261-2123 |
Jakob Carstens, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1 Professional Plz, Rexburg, ID 83440 Phone: 208-359-2500 Fax: 208-359-2502 | |
Clark Dabell, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1 Professional Plz, Rexburg, ID 83440 Phone: 208-359-2500 Fax: 208-359-2502 | |
Cordell Pickering, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 526 First American Cir Ste B, Rexburg, ID 83440 Phone: 208-534-7001 | |
Cody Lane Castellaw, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 393 E 2nd N, Rexburg, ID 83440 Phone: 208-359-9570 | |
Anthony Humphries, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1 Professional Plz, Rexburg, ID 83440 Phone: 208-359-2500 Fax: 208-359-2502 | |
Morgan Jesse Ricks, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 36 Winn Dr Ste 100, Rexburg, ID 83440 Phone: 208-356-0174 Fax: 208-356-0176 | |
George Garald Griffeth, MSPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 450 E Main St, Rexburg, ID 83440 Phone: 208-359-6532 |