NPIMap

Organization Active NPI

Myofascial Release Treatment Center of Idaho LLC

  • Physical Therapy Clinic/Center
  • Boise, ID
National Provider Identifier
1295897213
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
MYOFASCIAL RELEASE TREATMENT CENTER OF IDAHO LLC
Practice address
1556 S Timesquare LN
Boise, ID 83709-8269
Phone
(208) 321-7831
Fax
(208) 323-7651
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Authorized official

Name
Mrs. Linda Ann Chatburn, PTANPI 1437219185
Title
Ownermember
Phone
(208) 321-7831

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1556 S Timesquare LN
Boise, ID 83709-8269

Mailing address

1556 S Timesquare LN
Boise, ID 83709-8269
Phone (208) 321-7831

Other names 1

  • MYOFASCIAL RELEASE CENTER OF IDAHO Doing business as

National Provider Directory

National Provider Directory

Locations

1556 S Timesquare Ln
Boise, ID 83709
Phone (208) 321-7831

2404 W Bank Dr
Ste 101
Boise, ID 83705
Phone (208) 321-7831

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1295897213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1556 S TIMESQUARE LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837098269",
            "telephone_number": "208-321-7831",
            "fax_number": "208-323-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1556 S TIMESQUARE LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837098269",
            "telephone_number": "208-321-7831",
            "fax_number": "208-323-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYOFASCIAL RELEASE TREATMENT CENTER OF IDAHO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "CHATBURN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNERMEMBER",
        "authorized_official_telephone_number": "208-321-7831",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MYOFASCIAL RELEASE CENTER OF IDAHO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.