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1134848286
AMANDA LAGERSTROM
IDAHO FALLS, ID
NPI
1134848286
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: ID OT-2588)
Enumeration Date
2022-08-23
Last Update Date
2022-08-23
Business Address
AMANDA LAGERSTROM MOT OTR/L
3715 WOODKING DR
IDAHO FALLS, ID 83404-4720
Phone number: 208-529-2255
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Mailing Address
AMANDA LAGERSTROM MOT OTR/L
6070 S 2000 W
REXBURG, ID 83440-4441
Phone number:
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