OrganizationActive
Fitness Forward Physical Therapy PLLC
NPI 1881100261 · Physical Therapy Assistant · Idaho Falls, ID
Provider details
- NPI number
- 1881100261
- Entity type
- Organization
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Jon Mallams, Pta/Owner(208) 424-3999
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
1775 E 17th St Ste D
Idaho Falls, ID 83404-4902
Phone: (208) 243-9999
Fax: (208) 243-9999
Approximate (ZIP-level) locationGet directions
Mailing address
1775 E 17th St Ste D
Idaho Falls, ID 83404-4902
Registry dates
- Enumerated
- 2017-12-20
- Last updated
- 2017-12-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.