MA'LADY JANE KYNASTON PTA
Individual Provider (NPI-1)
Active
Physical Therapy Assistant
Provider Information
- NPI Number
1811720121- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PTA
- Status
- Active
Contact & Location
- Address
- 775 S RIVERSHORE LN STE 220, EAGLE, ID, 836165783
- Phone
- (208) 629-1030
Specialties & Taxonomies
Physical Therapy Assistant
Primary License: ID #PTA-4121
All Addresses
MAILING
2019 S ARCADIA ST
BOISE, ID, 837053335