PRO ORTHO PHYSICAL THERAPY PLLC (NPI# 1194241380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194241380 |
| Entity Type | Organization |
| Organization Name | PRO ORTHO PHYSICAL THERAPY PLLC |
| Other Organization Name | ADVANCED PERFORMANCE PHYSICAL THERAPHY ASSOCIATES PLLC |
| Practice Address |
2240 E Center St Pocatello ID 83201-2600 |
| Practice Telephone | 2084786780 |
| Practice Fax Number | 2084780194 |
| Mailing Telephone | 2084786780 |
| Mailing Fax Number | 2084780194 |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2018-01-25 |
| Authorized Official Name | ROBERT LANCE MARSHALL (OWNER) |
| Authorized Official Telephone | 2084786780 |
| Authorized Official Credential | DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
PT1003 | ID | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 1194241380 | 05 |
| Other Name | Type Code |
|---|---|
| Adavanced Performance Physical Therapy Associates | Doing Business As Name - Organization |
| Advanced Performance Physical Theraphy Associates PLLC | Former Legal Business Name - Organization |
| Street Address |
2240 E CENTER ST |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-2600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851385538 | Matthew L Mckinlay | Physician Assistant | 2240 E Center St, Pocatello, ID 83201 | 2005-09-08 |
| 1659870517 | Orthoidaho LLC | Family Medicine | 2240 E Center St, Pocatello, ID 83201-2600 | 2018-02-06 |
| 1013455914 | Mvh Surgical Specialists LLC | Surgery | 2240 E Center St, Pocatello, ID 83201-2600 | 2017-02-10 |
| 1366989659 | William Scott Harris | Physical Therapist | 2240 E Center St, Ste D, Pocatello, ID 83201-2600 | 2017-01-24 |
| 1336519891 | Timothy E. Snell, Md, Pllc | Pain Medicine | 2240 E Center St, Pocatello, ID 83201-2600 | 2015-09-28 |
| 1548649072 | Joni Lynn Johnson | Physical Therapist | 2240 E Center St, Suite D, Pocatello, ID 83201-2600 | 2015-05-29 |
| 1932510690 | Jordan Scott Anderson | Physical Therapist | 2240 E Center St, Pocatello, ID 83201-2600 | 2014-05-15 |
| 1548699465 | Physical Therapy Specialists of Idaho | Physical Therapist | 2240 E Center St, Suite D, Pocatello, ID 83201-2600 | 2013-11-01 |
| 1740553361 | Aaron J Altenburg Md PC | Orthopaedic Surgery | 2240 E Center St, Pocatello, ID 83201 | 2012-02-13 |
| 1205085529 | Annie Marie Dixon | Physician Assistant | 2240 E Center St, Pocatello, ID 83201 | 2008-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
| 1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
| 1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
| 1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
| 1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
| Find all providers in zip 83201 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811107394 | Kathleen Alexander | Physical Therapist | Mail Stop 8045, Pocatello, ID 83209-8045 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548878341 | Mckenna Briane Young | Physical Therapist | 910 Nw 16th St Ste 200, Fruitland, ID 83619-2265 | 2020-07-17 |
| 1235750746 | Sol Physiotherapy LLC | Physical Therapist | 804 N Whitley Dr, Fruitland, ID 83619-2437 | 2020-05-06 |
| 1205307485 | Scoliosis Treatment Center of Idaho | Physical Therapist | 2157 S Pebblecreek Ln, Boise, ID 83706-6123 | 2018-12-16 |
| 1972027431 | Robert Bernard Wendt | Physical Therapist | 904 White Ave, Moscow, ID 83843-3932 | 2017-07-26 |
| 1588924724 | Kevin Cherry | Physical Therapist | 243 Idaho St., Suite A, Gooding, ID 83330-1258 | 2012-05-22 |
| 1912116682 | Rulin J Hawks | Physical Therapist | 1902 S 10th Ave, Caldwell, ID 83605-4841 | 2007-05-21 |
| 1013137850 | Mark Morgan | Physical Therapist | 221 S River St, Hailey, ID 83333-8436 | 2007-04-26 |
| 1437210853 | Judith Lee Grucella | Physical Therapist | 4477 Emerald St Ste C125, Boise, ID 83706-2058 | 2006-12-12 |
| 1598862757 | David Marshal Saelens | Physical Therapist | 3322 N Grand Mill Ln, Coeur D Alene, ID 83814-5689 | 2006-09-20 |
| 1689770711 | Pro Motion Physical Therapy LLC | Physical Therapist | 1101 N 28th St, Boise, ID 83702-2208 | 2006-09-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.