| Eastern Idaho Physical Therapy | |
|
180 N Broadway St, Blackfoot, ID 83221-2203 | |
| (208) 785-0628 | |
| (208) 785-8667 |
| Full Name | Eastern Idaho Physical Therapy |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 180 N Broadway St, Blackfoot, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679810832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT-1288 (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Idaho Physical Therapy 180 N Broadway St, Blackfoot, ID 83221-2203 Ph: (208) 785-0628 | Eastern Idaho Physical Therapy 180 N Broadway St, Blackfoot, ID 83221-2203 Ph: (208) 785-0628 |
Tyce Alden Stewart, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 285 W Francis St, Blackfoot, ID 83221 Phone: 208-785-0123 Fax: 208-782-1885 | |
Bryan J. Gibby, MSPT, CWS Physical Therapist Medicare: Medicare Enrolled Practice Location: 1492 Christensen Dr, Blackfoot, ID 83221 Phone: 208-240-7221 | |
Jessica Annelaine Vandyke, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 282 W Bridge St, Blackfoot, ID 83221 Phone: 208-684-0021 | |
Brian Don Boehme, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1441 Parkway Dr, Blackfoot, ID 83221 Phone: 208-785-2600 | |
Pete Richar Johnson, Physical Therapist Medicare: Medicare Enrolled Practice Location: 131 N Oak St, Blackfoot, ID 83221 Phone: 208-684-2444 | |
Mr. Dustin Cade Schmitt, MPT, CSCS Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 285 W Francis St, Blackfoot, ID 83221 Phone: 208-785-0123 | |
Jonathan Dac-moang Liem, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1441 Parkway Dr Ste 1, Blackfoot, ID 83221 Phone: 208-785-3446 Fax: 208-980-7241 |