RAYMOND WAYNE

IDAHO FALLS, ID
NPI1386013373
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: ID  PTA-2712)
Enumeration Date2015-09-19
Last Update Date2015-09-19
Business Address
-- RAYMOND WAYNE PTA
3054 SANDSTONE DR
IDAHO FALLS, ID 83404-6824
Phone number: 208-522-0838
Mailing Address
-- RAYMOND WAYNE PTA
3054 SANDSTONE DR
IDAHO FALLS, ID 83404-6824
Phone number: 208-522-0838
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