Lane Marty Shockman, PTA

NPI #1487100376 in Hermiston, Oregon

Provider Information

NPI Number: 1487100376
Entity Type: Individual
Name: Lane Marty Shockman, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Aug 30, 2016
Last Updated: Aug 30, 2016

Practice Location

Address: 600 NW 11TH ST
Address 2: SUITE E31
City: Hermiston
State: Oregon
ZIP Code: 97838-8605
Phone: (541) 667-3657

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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