| Tri-city Physical Therapy, P.c. | |
|
275 E 7th St, Weiser, ID 83672-2303 | |
| (208) 549-1008 | |
| (208) 549-1396 |
| Full Name | Tri-city Physical Therapy, P.c. |
|---|---|
| Type | Facility |
| Speciality | Specialist |
| Location | 275 E 7th St, Weiser, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477573756 | NPI | - | NPPES |
| 804093200 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 174400000X | Specialist | (* (Not Available)) | Primary |
| Provider Name | Janeil M Heaton |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245205665 PECOS PAC ID: 8820064660 Enrollment ID: I20040902001435 |
| Provider Name | Craig L Hamann |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942248596 PECOS PAC ID: 5597778951 Enrollment ID: I20060801000408 |
| Provider Name | Cody Dee Stephens |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1174598593 PECOS PAC ID: 5799860052 Enrollment ID: I20080311000287 |
| Provider Name | Logan R. Bake |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1407265838 PECOS PAC ID: 9234465196 Enrollment ID: I20190730003150 |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-city Physical Therapy, P.c. 275 E 7th St, Weiser, ID 83672-2303 Ph: (208) 549-1008 | Tri-city Physical Therapy, P.c. 275 E 7th St, Weiser, ID 83672-2303 Ph: (208) 549-1008 |