LEEANN KRISTIN SHAW

POCATELLO, ID
NPI1326580663
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: ID  PTA-4587)
Enumeration Date2016-11-16
Last Update Date2016-11-16
Business Address
-- LEEANN KRISTIN SHAW
1957 ALVIN RICKEN DR
POCATELLO, ID 83201-2727
Phone number: 208-235-7800
Mailing Address
-- LEEANN KRISTIN SHAW
25117 SW PARKWAY AVE STE D
WILSONVILLE, OR 97070-9697
Phone number:
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