Reagan E Fernley, PTA

NPI #1881459543 in Homedale, Idaho

Provider Information

NPI Number
1881459543
Entity Type
Individual
Name
Reagan E Fernley, PTA
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physical Medicine & Rehabilitation - Sports Medicine
Credential
PTA
Enumeration Date
Feb 20, 2024
Last Updated
Feb 20, 2024

Practice Location

Address
134 E IDAHO AVE
State
Idaho
ZIP Code
83628-5003
Phone
(208) 337-3254

Specialties & Taxonomy Codes

Specialty
Physical Medicine & Rehabilitation - Sports MedicineSports Medicine

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