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

Proactive Physical Therapy PC

Organization Physical Therapist · NPI 1609093434

Proactive Physical Therapy PC is a Physical Therapist 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
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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