Individual
BRIAN J STANTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1005 6TH SOUTH, MOUNTAIN HOME, ID 83647-8364
(208) 587-1777
Mailing address
1650 LYNDON FARM CT STE 300, LOUISVILLE, KY 40223-5005
(951) 374-7288
(951) 665-5099
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1343415
ID
225100000X
Physical Therapist
1343415
TX
Other
Enumeration date
03/09/2021
Last updated
04/05/2023
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