NPI age
19 years
Enumerated 2006-10-23
● Active Type 2 · Organization
Pocatello Physical Therapy Clinic PA
Pocatello Physical Therapy Clinic PA is 1 of 2006 physical therapist organizations in Idaho.
Primary specialty
Physical Therapist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Des Fosses
President Owner
Last NPPES update
2011-05-10
Source: monthly bulk 2026-05
How this organization compares
Across 2006 active physical therapist providers in Idaho.
NPI age
19 years
↑ 8 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-10Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
1033 W Quinn Rd
Pocatello, ID 832022425
Mailing address
Po Box 2844
Pocatello, ID 832062844
Authorized official
Dan R Des Fosses, PT
President Owner
📞 2082334800
Individual providers at this organization
12 individual providers on file at this primary practice address.
- C Benedetti, DPT Physical Therapist NPI 1427147784
- Sarah Cairns, DPT Physical Therapist NPI 1295395903
- Marlene Cameron, PT Physical Therapist NPI 1548569148
- Amber Durrant, DPT Physical Therapist NPI 1366214181
- Richard Lemon, M.P.T. Physical Therapist NPI 1487646733
- Ernestine Miller, MS CCC-SLP Speech-Language Pathologist NPI 1376896019
- Jessica Mooney, DPT Physical Therapist NPI 1588030290
- Barbara Peterson, OCCUPT. THERAPIST Occupational Therapist NPI 1265490080
- Brittany Peterson, OTR/L Occupational Therapist NPI 1235360074
- Venita Petti, OT/L Occupational Therapist NPI 1982993937
- Elena Potter, DPT Physical Therapist NPI 1740172121
- Andrea Riley Physical Therapist NPI 1659150126
Specialties
-
Physical Therapist PrimaryPhysical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 002463600 | |
| 01 (ID) | 000010026861 | BLUE SHIELD |
| 01 (ID) | T0296 | BLUE CROSS |
Practice context
Multi-provider organization. 12 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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