| NPI | 1144918434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZION DANIEL DIXON Owner/Otr/L 208-819-4327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 261QR0400X Clinic/Center Rehabilitation |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2024-07-07 |