| Doctor Name: | ROBERT GRAY VINING |
| NPI Number: | 1518175686 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MPT |
| License Number: | 1158729 |
| Business Practice Address: | 943 N Linder Rd Suite 104 Kuna, ID - 836343394 |
| Business Phone Number: | 2089221719 |
| Business Fax Number: | 2083228710 |
| Mailing Address: | 2176 E Franklin Rd, Suite 100 MERIDIAN |
| State: | ID |
| Postal Code: | 836429024 |
| Phone Number: | 2082881155 |
| Fax Number: | 2082880424 |
| NPI Enumeration Date: | 05/20/2007 |
| NPI Last Update Date: | 02/25/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 1158729 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |