NPI age
17 years
Enumerated 2009-02-25
● Active Type 2 · Organization
Gridiron Rehab And Athletic Fitness, Llc
Gridiron Rehab And Athletic Fitness, Llc is 1 of 120 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Tamura
Administrator / Managing Employee
Last NPPES update
2018-05-17
Source: monthly bulk 2026-05
How this organization compares
Across 120 active clinic/center providers in Idaho.
NPI age
17 years
↑ 9 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2009 → 2026
2009-02Enumerated in NPPES
2009
2026
Where they practice
Primary practice location
3035 W McMillan Rd, Suite 104
Meridian, ID 83646
Mailing address
3035 W McMillan Rd, Suite 104
Meridian, ID 836466163
Authorized official
Eric Tamura
Administrator / Managing Employee
📞 2088878684
Individual providers at this organization
3 individual providers on file at this primary practice address.
- Andrew Campbell Physical Therapist NPI 1396538898
- Lynae Heninger, DPT, CSCS Physical Therapist NPI 1508164039
- Eric Tamura, DPT Physical Therapist NPI 1306121710
Specialties
-
Clinic/Center PrimaryAn entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy is a dynamic profession with an established theoretical and scientific base and...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 808389100 | |
| 01 (ID) | T9390 | BLUE CROSS |
Practice context
Multi-provider organization. 3 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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