NPI 1811720121

Ma'Lady Jane Kynaston, PTA

Practitioner Physical Therapy Assistant Eagle, ID

Practice location

Address: 775 S Rivershore Ln STE 220, Eagle, ID 83616-5783
Phone: (208) 629-1030
Mailing address: 2019 S Arcadia St, Boise, ID 83705-3335

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence PTA-4121 (ID)

Other Physical Therapy Assistant providers in Idaho →

Registry record

NPI: 1811720121
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Aug 2024
Record last updated: 25 Aug 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.