NPI 1104672682
Primary Therapy Source LLC
Practice location
- Address
- 254 River Vista Pl, Twin Falls, ID 83301-3006
- Phone
- (208) 734-7333
- Fax
- (208) 734-8350
Authorised official
- Name
- Deborah Jan Yingst
- Title
- Managing Member
- Phone
- (208) 734-7333
Registered specialties (2)
Durable Medical Equipment & Medical Supplies
Primary
Customized Equipment (DME)
Registry record
- NPI
- 1104672682
- Entity type
- Organization
- NPI issued
- 25 Apr 2024
- Record last updated
- 25 Apr 2024
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.