LANE MARTY SHOCKMAN

HERMISTON, OR
NPI1487100376
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: OR  09190)
Enumeration Date2016-08-30
Last Update Date2016-08-30
Business Address
-- LANE MARTY SHOCKMAN PTA
600 NW 11TH ST SUITE E31
HERMISTON, OR 97838-8605
Phone number: 541-667-3657
Mailing Address
-- LANE MARTY SHOCKMAN PTA
600 N.W 11TH SUITE E31
HERMISTON, OR 97838
Phone number: 541-667-3657
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