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1780952093
JERRALYN R WASYLYSHEN
CHUBBUCK, ID
NPI
1780952093
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: ID PT-1796)
Enumeration Date
2011-12-01
Last Update Date
2011-12-01
Business Address
-- JERRALYN R WASYLYSHEN PT
4650 HAWTHORNE RD STE 2B
CHUBBUCK, ID 83202-2376
Phone number: 208-238-3349
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Mailing Address
-- JERRALYN R WASYLYSHEN PT
PO BOX 6032
POCATELLO, ID 83205-6032
Phone number: 208-238-3349
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