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1295143147
SHANE GRAYSON
TWIN FALLS, ID
NPI
1295143147
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: ID PTA-3681)
Enumeration Date
2014-07-23
Last Update Date
2014-07-23
Business Address
SHANE GRAYSON PTA
182 FALLS AVE W
TWIN FALLS, ID 83301-3595
Phone number: 208-995-7842
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Mailing Address
SHANE GRAYSON PTA
182 FALLS AVE W
TWIN FALLS, ID 83301-3595
Phone number: 208-995-7842
Copy
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