Provider Demographics
NPI:1689295529
Name:AT HOME PHYSICAL THERAPY SERVICES, PLLC
Entity Type:Organization
Organization Name:AT HOME PHYSICAL THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:GARTON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:801-791-1320
Mailing Address - Street 1:9816 W HIDDEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:RATHDRUM
Mailing Address - State:ID
Mailing Address - Zip Code:83858-6733
Mailing Address - Country:US
Mailing Address - Phone:801-791-1320
Mailing Address - Fax:
Practice Address - Street 1:9816 W HIDDEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:RATHDRUM
Practice Address - State:ID
Practice Address - Zip Code:83858-6733
Practice Address - Country:US
Practice Address - Phone:801-791-1320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty