Provider Demographics
NPI:1598456295
Name:CURRENT PHYSICAL THERAPY CALDWELL
Entity Type:Organization
Organization Name:CURRENT PHYSICAL THERAPY CALDWELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:541-212-0037
Mailing Address - Street 1:119 S VALLEY DR STE A
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-2985
Mailing Address - Country:US
Mailing Address - Phone:208-800-1619
Mailing Address - Fax:
Practice Address - Street 1:1906 FAIRVIEW AVE STE 120
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-5425
Practice Address - Country:US
Practice Address - Phone:208-606-5384
Practice Address - Fax:208-600-0649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty