Provider Demographics
NPI:1801900212
Name:INTERMOUNTAIN PHYSICAL THERAPY LIMITED PARTNERSHIP
Entity type:Organization
Organization Name:INTERMOUNTAIN PHYSICAL THERAPY LIMITED PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-297-7000
Mailing Address - Street 1:1300 W SAM HOUSTON PKWY S
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-2447
Mailing Address - Country:US
Mailing Address - Phone:713-297-7000
Mailing Address - Fax:713-297-7090
Practice Address - Street 1:3110 CLEVELAND BLVD
Practice Address - Street 2:BUILDING A SUITE 5
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-0718
Practice Address - Country:US
Practice Address - Phone:208-453-8785
Practice Address - Fax:208-453-8776
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERMOUNTAIN PHYSICAL THERAPY LIMITED PARTNERSHIP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-19
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID136528Medicare Oscar/Certification