OrganizationActive
Full Potential Physical Therapy, PLLC
NPI 1477093334 · Physical Therapy Clinic/Center · Lewiston, ID
Provider details
- NPI number
- 1477093334
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Saker Medavarapu, Physical Therapist
- License
- PT-1243 (ID)
Practice location
450 Thain Rd Ste a
Lewiston, ID 83501-5300
Phone: (208) 816-8836
Fax: (208) 621-2995
Mailing address
450 Thain Rd Ste a
Lewiston, ID 83501-5300
Registry dates
- Enumerated
- 2017-02-26
- Last updated
- 2023-11-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.