Individual
SHELBY ANN MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3111 CHANNING WAY, IDAHO FALLS, ID 83404-7534
(208) 529-0067
Mailing address
627 VALINDA LN, REXBURG, ID 83440-2358
(208) 703-6606
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-5332
ID
Other
Enumeration date
01/03/2018
Last updated
01/03/2018
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