CODY LANE CASTELLAW

REXBURG, ID
NPI1154728426
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: ID  PT-3504)
Enumeration Date2014-12-02
Last Update Date2014-12-02
Business Address
-- CODY LANE CASTELLAW DPT
393 E 2ND N
REXBURG, ID 83440-1605
Phone number: 208-359-9570
Mailing Address
-- CODY LANE CASTELLAW DPT
393 E 2ND N
REXBURG, ID 83440-1605
Phone number: 208-359-9570
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