Graduated: 2023
Offers telehealth
NPI: 1467138636
Practice Locations (2)
CUSTOM REHAB LLC
265 E CHUBBUCK RD A
CHUBBUCK, ID 832015055
2084170011
SHELLMAN INC PA
30544 HWY 200, SUITE 326
PONDERAY, ID 838525042
2082059559
Source: CMS National Downloadable File, September 2026.