OrganizationActive
62 Degrees Physical Therapy
NPI 1154743912 · Physical Therapist · Boise, ID
Provider details
- NPI number
- 1154743912
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Katrin Moffett, Owner/Member(208) 321-7831
- License
- PT632 (ID)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
8660 W Emerald St
Boise, ID 83704-4825
Phone: (208) 321-7831
Fax: (208) 995-2870
Approximate (ZIP-level) locationGet directions
Mailing address
8660 W Emerald St
Boise, ID 83704-4825
Other names (DBA / former)
- Doing business as
- Myofascial Release Center
Registry dates
- Enumerated
- 2014-01-14
- Last updated
- 2014-01-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.