Raymond Wayne, PTA
NPI #1386013373 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1386013373
- Entity Type
- Individual
- Name
- Raymond Wayne, PTA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physical Therapy Assistant
- Credential
- PTA
- Enumeration Date
- Sep 19, 2015
- Last Updated
- Sep 19, 2015
Practice Location
- Address
- 3054 SANDSTONE DR
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-6824
- Phone
- (208) 522-0838
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapy Assistant |
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