| Custom Rehab Llc | |
|
265 E Chubbuck Rd, Chubbuck, ID 83202-5055 | |
| (208) 244-1882 | |
| Not Available |
| Full Name | Custom Rehab Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 265 E Chubbuck Rd, Chubbuck, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215204862 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Provider Name | Sadie Ellis |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1326285560 PECOS PAC ID: 6709933369 Enrollment ID: I20090416000589 |
| Provider Name | Jared L Mckee |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649401407 PECOS PAC ID: 3577617893 Enrollment ID: I20090820000235 |
| Provider Name | Daniel M Barclay |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376752279 PECOS PAC ID: 6800150160 Enrollment ID: I20180514002274 |
| Provider Name | Sophia M Garrett |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1124639653 PECOS PAC ID: 9931527223 Enrollment ID: I20200918000825 |
| Provider Name | Russell Taylor Farnsworth |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528503083 PECOS PAC ID: 2860775269 Enrollment ID: I20211027000315 |
| Provider Name | Katrina K Rhett |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1548990187 PECOS PAC ID: 4880077023 Enrollment ID: I20220819002400 |
| Mailing Address | Practice Location Address |
|---|---|
| Custom Rehab Llc 857 Sheba Rd, Chubbuck, ID 83202-2522 Ph: (208) 244-1882 | Custom Rehab Llc 265 E Chubbuck Rd, Chubbuck, ID 83202-5055 Ph: (208) 244-1882 |
Derrick Northrup, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 605 Taylor Ln, Chubbuck, ID 83202 Phone: 208-221-6952 Fax: 844-946-0909 | |
Sophia M Garrett, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 265 E Chubbuck Rd Ste A, Chubbuck, ID 83202 Phone: 208-417-0011 Fax: 888-437-2431 | |
Flicker Physical Therapy Llc Physical Therapist Medicare: Medicare Enrolled Practice Location: 4922 Yellowstone Ave Ste J, Chubbuck, ID 83202 Phone: 208-237-1882 Fax: 208-904-2990 | |
Dr. Timothy Andrew Flicker, MPT, DPT, CSCS Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4922 Yellowstone Ave Ste J, Chubbuck, ID 83202 Phone: 208-237-1882 | |
Sarah Ingalls, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4425 Burley Dr, Chubbuck, ID 83202 Phone: 208-637-1100 | |
Hannah's Place Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 240 W Burnside Ave Ste D, Chubbuck, ID 83202 Phone: 208-904-1112 Fax: 866-818-2688 |