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1679964977
IDRIS JAMAL SHELBY
TWIN FALLS, ID
NPI
1679964977
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: ID OTA-1029)
Enumeration Date
2015-02-09
Last Update Date
2015-02-09
Business Address
Mr. IDRIS JAMAL SHELBY
2681 SAGEBRUSH DR
TWIN FALLS, ID 83301-7559
Phone number: 208-794-7964
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Mailing Address
Mr. IDRIS JAMAL SHELBY
2681 SAGEBRUSH DR
TWIN FALLS, ID 83301-7559
Phone number: 208-794-7964
Copy
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