OrganizationActive
Jump Start Pediatric Therapy, LLC
NPI 1144494105 · Physical Therapy Clinic/Center · Coeur D Alene, ID
Provider details
- NPI number
- 1144494105
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Ellison Sanders, Owner / Physical Therapist(208) 664-2468
- License
- PT-2061 (ID)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
411 W Haycraft Ave
Ste B3
Coeur D Alene, ID 83815-8105
Phone: (208) 664-2468
Fax: (208) 667-6239
Approximate (ZIP-level) locationGet directions
Mailing address
411 W Haycraft Ave
Coeur D Alene, ID 83815-8105
Registry dates
- Enumerated
- 2008-04-21
- Last updated
- 2012-01-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.