Provider Demographics
NPI:1417613571
Name:PICK PT PHYSICAL THERAPY RIGBY
Entity type:Organization
Organization Name:PICK PT PHYSICAL THERAPY RIGBY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:MAKAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-789-0202
Mailing Address - Street 1:711 RIGBY LAKE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:RIGBY
Mailing Address - State:ID
Mailing Address - Zip Code:83442-5230
Mailing Address - Country:US
Mailing Address - Phone:208-754-1210
Mailing Address - Fax:208-754-1220
Practice Address - Street 1:711 RIGBY LAKE DR STE 102
Practice Address - Street 2:
Practice Address - City:RIGBY
Practice Address - State:ID
Practice Address - Zip Code:83442-5230
Practice Address - Country:US
Practice Address - Phone:208-754-1210
Practice Address - Fax:208-754-1220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-12
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty