Individual
SHANNA MARIE HERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
405 W MYRTLE ST, BOISE, ID 83702-7658
(208) 385-3420
(208) 385-3421
Mailing address
405 W MYRTLE ST, BOISE, ID 83702-7658
(208) 385-3420
(208) 385-3421
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-4287
ID
Other
Enumeration date
11/10/2015
Last updated
11/10/2015
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