Individual
MICHAEL LAFFERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
331 E PARK ST, WEISER, ID 83672-2053
(208) 549-2416
Mailing address
331 E PARK ST, WEISER, ID 83672-2053
(208) 549-2416
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-3058
ID
Other
Enumeration date
08/08/2013
Last updated
08/08/2013
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