Individual
MR. BENJAMIN NATHANIEL SHATTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
7550 W EMERALD ST, BOISE, ID 83704-9015
(208) 375-0666
(208) 375-2996
Mailing address
1650 LYNDON FARM CT STE 300, LOUISVILLE, KY 40223-5005
(951) 374-7288
(951) 666-5099
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1883
ID
Other
Enumeration date
10/03/2006
Last updated
03/30/2023
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