BK Inc.
Organization Active NPI Physical Therapy Clinic/Center · Moscow, ID
NPI 1659429405 · NPPES record last updated Aug 17, 2007
Key facts
- NPI
- 1659429405
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- Legal business name
- BK INC.
- Practice address
- 872 Troy Rd Ste 180
Moscow, ID 83843-4046 - Phone
- (208) 882-1426
- Fax
- (208) 882-1428
- NPI assigned
- Jan 8, 2007
- Organization subpart
- No
Authorized official
- Name
- Kelly Isakson, PT
- Title
- Owner
- Phone
- (208) 882-1426
Practitioners 14
-
Brenda Boyko, P.T.
-
Marie Eriksson, P.T.
-
Douglas A Houle, MSPT
-
Cassie Endsley, DPT
-
Matthew Godfrey, PT, DPT
-
Amanda Black, MOT, OTR/L
-
Zachary J Eagle, PT
-
Hilary Eleanor Snell, DPT
-
Robyn Tramposh, PT
-
Dayna K. Willbanks, OTR/L
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070828000276 | ID | Part B Supplier - Clinic/Group Practice | 6406948090 |
Receives reassigned benefits from 8 practitioners Practice locations: Moscow, ID |
National Provider Directory
Locations
904 White Ave
Moscow, ID 83843
Phone (208) 596-1056
872 Troy Rd
Ste 180
Moscow, ID 83843
Phone (208) 882-1426
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | Yes |
Addresses
Primary practice location
872 Troy Rd Ste 180
Moscow, ID 83843-4046
Mailing address
872 Troy Rd Ste 180
Moscow, ID 83843-4046
Phone (208) 882-1426
Other names
- Moscow Mountain Sport and Physical Therapy
Other providers in Moscow, ID
- Stephen Alexander Bergdahl
- Victoria Bernard
- Better Psych, LLC
- Erin Bierstedt
- Madison Nicole Bittle
- Erik Blaker
- Kimberley D Blewett
- Bloomin Family Therapy, LLC
- Bluesky Dental
- Elizabeth Bonanni
All providers in Moscow, ID · Physical Therapy Clinic/Center in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.