MOUNTAIN INTEGRATED THERAPY PLLC
Physical Therapy at State St, Preston, ID

License number
Idaho PT-480
Category
Restorative Service Providers
Type
Physical Therapist
Owner
Name: DOUGLAS COX
Title: OWNER
Phone: (208) 604-1375
Address
Address
8 S State St, Preston, ID 83263
National Provider ID: 1003187063
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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MOUNTAIN INTEGRATED THERAPY, PLLC

Preston, ID

Status:
Inactive
Industry:
Specialty Outpatient Clinic
Registration:
Jan 23, 2012
Inactive since:
Apr 14, 2014
Addresses:
8 South State St, Preston, ID 83263 (Physical)
8 S State St, Preston, ID 83263
State ID:
W110346
Business type:
LIMITED LIABILITY COMPANY
Owner:
Douglas P. Cox (Owner)
Agent:
Douglas P Cox,8 South State St, Preston, ID 83263 (Physical)

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