Provider Demographics
NPI:1528150091
Name:TK HOWELL ENTERPRISES INC
Entity type:Organization
Organization Name:TK HOWELL ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ANGELA
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:208-336-9755
Mailing Address - Street 1:539 S FITNESS PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-6552
Mailing Address - Country:US
Mailing Address - Phone:208-336-9755
Mailing Address - Fax:208-336-8605
Practice Address - Street 1:539 S FITNESS PL
Practice Address - Street 2:SUITE 100
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-6552
Practice Address - Country:US
Practice Address - Phone:208-336-9755
Practice Address - Fax:208-336-8605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID5426929OtherCCN
IDT-0213OtherBLUE CROSS IDAHO GROUP #
ID2078931OtherFIRST HEALTH
ID1652691Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER