Provider Demographics
NPI:1083892988
Name:NEW DAY PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:NEW DAY PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:WHEELER
Authorized Official - Last Name:SCHWARZE
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:208-237-2080
Mailing Address - Street 1:1951 BENCH RD STE E
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-2073
Mailing Address - Country:US
Mailing Address - Phone:208-237-2080
Mailing Address - Fax:208-237-1084
Practice Address - Street 1:1951 BENCH RD STE E
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-2073
Practice Address - Country:US
Practice Address - Phone:208-237-2080
Practice Address - Fax:208-237-1084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1652937Medicare PIN