Provider Demographics
NPI:1811951841
Name:BBPT INC
Entity type:Organization
Organization Name:BBPT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:HUTCHINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:208-934-9011
Mailing Address - Street 1:423 IDAHO ST STE A
Mailing Address - Street 2:
Mailing Address - City:GOODING
Mailing Address - State:ID
Mailing Address - Zip Code:83330-1258
Mailing Address - Country:US
Mailing Address - Phone:208-934-9011
Mailing Address - Fax:208-934-9014
Practice Address - Street 1:423 IDAHO ST STE A
Practice Address - Street 2:
Practice Address - City:GOODING
Practice Address - State:ID
Practice Address - Zip Code:83330-1258
Practice Address - Country:US
Practice Address - Phone:208-934-9011
Practice Address - Fax:208-934-9014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDP00099594OtherRAILROAD MEDICARE
IDT8950OtherBLUE CROSS
ID10146656OtherBLUE SHIELD
ID806872200Medicaid
IDP00099594OtherRAILROAD MEDICARE
ID1376669Medicare ID - Type Unspecified