Willow Creek Physical & Sports Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-1026 Issued in ID

Legal business name

WILLOW CREEK PHYSICAL & SPORTS THERAPY

Practice address

790 Hollyann CT
Twin Falls, ID 83301-3418

Phone

(208) 735-8330

Fax

(208) 734-6689

NPI assigned

Mar 19, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bradley C. Williams, RPT

Title

Managing Member

Phone

(208) 735-8330

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205884800000",
    "number": "1124299045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1886",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833031886",
            "telephone_number": "208-736-0887",
            "fax_number": "208-736-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 HOLLYANN CT",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013418",
            "telephone_number": "208-735-8330",
            "fax_number": "208-734-6689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW CREEK PHYSICAL & SPORTS THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2008-03-19",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "208-735-8330",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-1026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spencer Geyer Williams, DC
• Tiara Mae Williams, LMSW
• Troy Alan Williams, DDS MDS
• Vincent L Williams, DMD,PA
• Neelie Berlin Willis, PA-C
• Willowbrook LLC
• Erika L Willsey
• Mallory Antonetta Wilson, SUDA
• Evelyn Claire Wiltse, RD, LD
• Wings Charter Middle School, Inc.

• Physical Therapist in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.