Individual
MRS. SHAYLA RAE LANEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1117 17TH ST, LEWISTON, ID 83501-3059
(208) 305-6501
Mailing address
1117 17TH ST, LEWISTON, ID 83501-3059
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/01/2018
Last updated
06/01/2018
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