Jerome Physical Therapy & Sports Medicine Clinic

LBN: Lon M. Egbert, P.C.
Jerome Physical Therapy & Sports Medicine Clinic is an health care organization with primary practice located at 128 5Th Ave West , Jerome ID 83338. The organization recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is the primary health care specialty. Lon M. Egbert, P.C. can be contacted via phone (208) 324-3090, or through Egbert, Lon M via phone (208) 324-3090.

Contact Information

Primary practice address
128 5Th Ave West Jerome ID 83338
Phone: (208) 324-3090
Fax: (208) 324-3093
Website:
Map and Directions
Authorized official contact:
Name: Egbert, Lon M PT, ATC
Phone: (208) 324-3090

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT-1686 Idaho
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X PENDING Idaho

Profile Details

NPI number 1265527725
LBN Legal business name Lon M. Egbert, P.C.
DBA Doing business as Jerome Physical Therapy & Sports Medicine Clinic
Authorized official Egbert, Lon M PT, ATC
Entity Organization
Organization subpart 1 No
Enumeration date Oct 3rd, 2006
Last updated Jan 15th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1265527725 NPPES
Idaho MEDICAID PENDING

Popular Providers