Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Proactive Physical Therapy PC

Organization Physical Therapist · NPI 1609093434

Proactive Physical Therapy PC provides Physical Therapist services in Burley, Idaho. Licensed in Idaho. Registered with an NPI since 2007.

Licensed in
ID
In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2311 Park Ave Ste 2
Burley, ID 83318-2170 Not confirmed with CMS for 16 years — call before visiting
Phone: (208) 677-2489
Fax: (208) 677-4023
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT1299 (ID)

Record details

NPI number1609093434
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Raulan Young — President · (208) 677-2489
NPI enumeratedApril 20, 2007
Last updated in NPPESOctober 13, 2010
Mailing address2311 Park Ave, Suite 2, Burley, ID 83318-2170

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