Individual
ROBERT GRAY VINING III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
943 N LINDER RD, SUITE 104, KUNA, ID 83634-3394
(208) 922-1719
(208) 322-8710
Mailing address
2176 E FRANKLIN RD, SUITE 100, MERIDIAN, ID 83642-9024
(208) 288-1155
(208) 288-0424
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
1158729
TX
2251X0800X
Orthopedic Physical Therapist
Primary
PT-2806
ID
Other
Enumeration date
05/20/2007
Last updated
02/25/2011
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