SHANE GRAYSON

TWIN FALLS, ID
NPI1295143147
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: ID  PTA-3681)
Enumeration Date2014-07-23
Last Update Date2014-07-23
Business Address
-- SHANE GRAYSON PTA
182 FALLS AVE W
TWIN FALLS, ID 83301-3595
Phone number: 208-995-7842
Mailing Address
-- SHANE GRAYSON PTA
182 FALLS AVE W
TWIN FALLS, ID 83301-3595
Phone number: 208-995-7842
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