OrganizationActive
Functional Physical Therapy Center
NPI 1902182298 · Physical Therapy Clinic/Center · Boise, ID
Provider details
- NPI number
- 1902182298
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Rajcoomar Issuree, Physical Therapist/Director(208) 376-7313
- License
- PT670 (ID)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
8950 W Emerald St
Suite 195
Boise, ID 83704-4854
Phone: (208) 376-7313
Fax: (208) 376-7487
Approximate (ZIP-level) locationGet directions
Mailing address
8950 W Emerald St
Boise, ID 83704-4854
Registry dates
- Enumerated
- 2011-10-31
- Last updated
- 2012-04-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.