Individual
STANLEY RYAN PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1053 EASTLAND DR, TWIN FALLS, ID 83301-6747
(208) 736-9011
Mailing address
478 LOIS ST, TWIN FALLS, ID 83301-7636
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6264
ID
Other
Enumeration date
08/01/2019
Last updated
08/01/2019
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