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Individual

BRYAN PHILIP LAWSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
920 DEON DR, STE D, POCATELLO, ID 83201
(208) 425-1470
(108) 425-1471
Mailing address
920 DEON DR, STE D, POCATELLO, ID 83201
(208) 425-1470
(108) 425-1471

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT-6198
ID

Other

Enumeration date
06/18/2019
Last updated
07/25/2024
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