OrganizationActive
Prime Physical Therapy LLC
NPI 1851051718 · Physical Therapy Clinic/Center · Blackfoot, ID
Provider details
- NPI number
- 1851051718
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jessica Vandyke, Owner(208) 233-2248
Specialties & taxonomies
Ambulatory Health Care Facilities
- Physical Therapist225100000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
30 S Maple St
Blackfoot, ID 83221-2128
Phone: (208) 684-0021
Approximate (ZIP-level) locationGet directions
Mailing address
30 S Maple St
Blackfoot, ID 83221-2128
Registry dates
- Enumerated
- 2021-12-20
- Last updated
- 2025-10-15
- Certified
- 2025-10-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.