Provider Demographics
NPI:1891451621
Name:KEY PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:KEY PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUERCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:208-994-5323
Mailing Address - Street 1:2831 E BERGESON ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-5760
Mailing Address - Country:US
Mailing Address - Phone:208-994-5323
Mailing Address - Fax:
Practice Address - Street 1:3350 W AMERICANA TERRACE
Practice Address - Street 2:210 A ROOM 3
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706
Practice Address - Country:US
Practice Address - Phone:208-994-5323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy