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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 6 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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