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DOUGLAS ANDERSON COTA/L, CEAS

>> Occupational Therapy Assistant >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1497183396

Individual Registrant:
 DOUGLAS  ANDERSON COTA/L, CEAS
Gender: M
Not Sole Proprietor

Location and contact information for practice:
234 CARNEY ST  TWIN FALLS, ID 83301-5010 US
Tel: 208-410-0607  Fax: --

Contact information for business:
234 CARNEY ST  TWIN FALLS, ID 83301-5010 US
Tel: 208-410-0607  Fax: --

Registration Information:
NPI: 1497183396
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Occupational Therapy Assistant
IDOTA-063

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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