Basic Information
| Provider Information | |||||||||
| NPI: | 1609196062 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | WORLD IS ROUND PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 302 S 1ST AVE STE C | ||||||||
| Address2: | |||||||||
| City: | SANDPOINT | ||||||||
| State: | ID | ||||||||
| PostalCode: | 838641259 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2082650610 | ||||||||
| FaxNumber: | 2082659192 | ||||||||
| Practice Location | |||||||||
| Address1: | 302 S 1ST AVE STE C | ||||||||
| Address2: | |||||||||
| City: | SANDPOINT | ||||||||
| State: | ID | ||||||||
| PostalCode: | 838641259 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2082650610 | ||||||||
| FaxNumber: | 2082659192 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2010 | ||||||||
| LastUpdateDate: | 06/09/2010 | ||||||||
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| AuthorizedOfficialLastName: | RUST | ||||||||
| AuthorizedOfficialFirstName: | CHRISTINA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 2082650610 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DPT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | RPT-1097 | ID | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.