ASA GENTRY

BOISE, ID
NPI1689035040
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: ID  PTA-3056)
Enumeration Date2016-03-14
Last Update Date2016-03-14
Business Address
-- ASA GENTRY
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-2138
Mailing Address
-- ASA GENTRY
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-2138
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