Provider Demographics
NPI:1336814250
Name:CURRENT PHYSICAL THERAPY WEISER LLC
Entity Type:Organization
Organization Name:CURRENT PHYSICAL THERAPY WEISER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
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 1:770 E. 1ST ST. SUITE B
Mailing Address - Street 2:
Mailing Address - City:WEISER
Mailing Address - State:ID
Mailing Address - Zip Code:83672
Mailing Address - Country:US
Mailing Address - Phone:208-718-0827
Mailing Address - Fax:
Practice Address - Street 1:770 E. 1ST ST. SUITE B
Practice Address - Street 2:
Practice Address - City:WEISER
Practice Address - State:ID
Practice Address - Zip Code:83672
Practice Address - Country:US
Practice Address - Phone:208-718-0827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty