NPI age
8 years
Enumerated 2017-12-20
● Active Type 2 · Organization
Fitness Forward Physical Therapy Pllc
Fitness Forward Physical Therapy Pllc is 1 of 272 physical therapy assistant organizations in Idaho.
Primary specialty
Physical Therapy Assistant
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Mallams
Pta/owner
Last NPPES update
2017-12-20
Source: monthly bulk 2026-05
How this organization compares
Across 272 active physical therapy assistant providers in Idaho.
NPI age
8 years
≈ at median (9 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2017 → 2026
2017-12Enumerated in NPPES
2017
2026
Where they practice
Primary practice location
1775 E 17th St Ste D
Idaho Falls, ID 834044902
Mailing address
1775 E 17th St Ste D
Idaho Falls, ID 834044902
Authorized official
Jon Christopher Mallams, PTA
Pta/owner
📞 2084243999
Specialties
-
Physical Therapy Assistant Primary(1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | PTA-3754 | STATE LICENSE |
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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