SHANTAY ANDERSON
Individual Provider (NPI-1)
Active
Physical Therapy Assistant
Provider Information
- NPI Number
1942829205- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 527 MEMORIAL DR, POCATELLO, ID, 832014063
- Phone
- (208) 478-3333
Specialties & Taxonomies
Physical Therapy Assistant
License: UT #11433285-2402
Physical Therapy Assistant
Primary License: ID #PTA-6180