Individual
ERICA JOY SHEPPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3025 W CHERRY LN STE D, MERIDIAN, ID 83642-8531
(208) 367-8970
Mailing address
56 N STANFORD ST, NAMPA, ID 83651-2356
(208) 318-3895
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4620
ID
Other
Enumeration date
04/05/2018
Last updated
04/05/2018
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