| Physical Therapy 180 | |
|
5909 W State Street, Boise, ID 83703 | |
| (208) 343-7700 | |
| (208) 331-2591 |
| Full Name | Physical Therapy 180 |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 5909 W State Street, Boise, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669696910 | NPI | - | NPPES |
| 808631800 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Provider Name | Paula A Kosberg |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770878779 PECOS PAC ID: 8022287572 Enrollment ID: I20110817000913 |
| Provider Name | Gina R Collins |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871678037 PECOS PAC ID: 3072520758 Enrollment ID: I20170221002911 |
| Provider Name | Evan Anne Gustavsen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932754496 PECOS PAC ID: 8527397918 Enrollment ID: I20190910003291 |
| Provider Name | Sebastian Thomas Saur |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1740830801 PECOS PAC ID: 3870925456 Enrollment ID: I20191120001574 |
| Provider Name | Taylor N Williams |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639793953 PECOS PAC ID: 0143642660 Enrollment ID: I20200629003206 |
| Provider Name | Austin L Adams |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1356953301 PECOS PAC ID: 1951702182 Enrollment ID: I20210625001112 |
| Mailing Address | Practice Location Address |
|---|---|
| Physical Therapy 180 5909 W State Street, Boise, ID 83703 Ph: (208) 343-7700 | Physical Therapy 180 5909 W State Street, Boise, ID 83703 Ph: (208) 343-7700 |
Mrs. Dianne Denise Nelson, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1130 Allumbaugh St, Boise, ID 83704 Phone: 208-854-8517 | |
Peter H Kolb, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 901 N Curtis Rd Ste 204, Boise, ID 83706 Phone: 208-367-3315 Fax: 208-367-2674 | |
Melissa Pirtle, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 703 S Americana Blvd, Suite 130, Boise, ID 83702 Phone: 208-706-7530 Fax: 208-706-7531 | |
Kyle Aaron Holbrook, PT, DPT, NCS Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 600 N Robbins Rd, Boise, ID 83702 Phone: 208-489-4444 | |
Rebecca Wensel, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 190 E Bannock St, Boise, ID 83712 Phone: 208-381-2138 | |
Bridget Gilbertson, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 703 S Americana Blvd Ste 130, Boise, ID 83702 Phone: 208-706-7530 | |
Idaho Physical Therapy Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1175 E Parkcenter Blvd, Ste 101, Boise, ID 83706 Phone: 208-367-1010 |