PRESTON ROGER POULTER

IDAHO FALLS, ID
NPI1154172245
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225X00000X Occupational Therapist
(Licence: ID  OT-2860)
Enumeration Date2024-03-28
Last Update Date2024-04-02
Business Address
PRESTON ROGER POULTER OTR/L MSOT
564 S WOODRUFF AVE
IDAHO FALLS, ID 83401-5298
Phone number: 208-523-7571
Mailing Address
PRESTON ROGER POULTER OTR/L MSOT
564 S WOODRUFF AVE
IDAHO FALLS, ID 83401-5298
Phone number: 208-523-7571
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