WILLIAM DAVID PENTECOST

WEISER, ID
NPI1033542196
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: ID  OTA-168)
Enumeration Date2013-08-13
Last Update Date2013-08-13
Business Address
Mr. WILLIAM DAVID PENTECOST COTA
331 E PARK ST
WEISER, ID 83672-2053
Phone number: 208-549-0206
Mailing Address
Mr. WILLIAM DAVID PENTECOST COTA
1486 W COLVILLE CT
EAGLE, ID 83616-4869
Phone number: 208-954-3691
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