Jerralyn R Wasylyshen, PT

NPI #1780952093 in Chubbuck, Idaho

Provider Information

NPI Number: 1780952093
Entity Type: Individual
Name: Jerralyn R Wasylyshen, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Dec 1, 2011
Last Updated: Dec 1, 2011

Practice Location

Address: 4650 HAWTHORNE RD STE 2B
City: Chubbuck
State: Idaho
ZIP Code: 83202-2376
Phone: (208) 238-3349

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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