Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Prime Physical Therapy LLC

Organization Physical Therapist · NPI 1851051718

Prime Physical Therapy LLC is a Physical Therapist in Blackfoot, Idaho. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

30 S Maple St
Blackfoot, ID 83221-2128
Phone: (208) 684-0021
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Clinic/Center (primary) Taxonomy 261QP2000X
Physical Therapist Taxonomy 225100000X

Record details

NPI number1851051718
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jessica Vandyke — Owner · (208) 233-2248
NPI enumeratedDecember 20, 2021
Last updated in NPPESOctober 15, 2025
Certification dateOctober 15, 2025
Mailing address30 S Maple St, Blackfoot, ID 83221-2128

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