NICKALUS SHANE DAVIS

BOISE, ID
NPI1336615749
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: ID  PT-5619)
Enumeration Date2018-10-23
Last Update Date2023-04-18
Business Address
NICKALUS SHANE DAVIS PT
1010 S ALLANTE PL STE 101
BOISE, ID 83709-1660
Phone number: 208-370-5166
Mailing Address
NICKALUS SHANE DAVIS PT
1010 S ALLANTE PL STE 101
BOISE, ID 83709-1660
Phone number: 208-370-5166
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