Anderson, Shantay
Anderson, Shantay is an individual health care provider with primary practice located at 527 Memorial Dr , Pocatello ID 83201-4063. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Anderson, Shantay can be contacted via phone (208) 478-3333.Contact Information
Primary practice address
527 Memorial Dr
Pocatello ID 83201-4063
Phone: (208) 478-3333
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant | 225200000X | 11433285-2402 | Utah |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant | 225200000X | PTA-6180 | Idaho |
Profile Details
NPI number | 1942829205 |
---|---|
LBN Legal business name | Anderson, Shantay |
Credentials | |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 15th, 2020 |
Last updated | Apr 15th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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