Individual
DR. JASON SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT, DA
Contact information
Practice address
4542 E 280 N, RIGBY, ID 83442-5885
(208) 538-7382
Mailing address
PO BOX 322, REXBURG, ID 83440-0322
(208) 359-2500
(208) 359-2502
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-938
ID
Other
Enumeration date
07/30/2008
Last updated
01/27/2017
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