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1194173344
JESSICA PORTER COOK
REXBURG, ID
NPI
1194173344
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Former Name
JESSICA PORTER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: ID OTL- 1609)
Enumeration Date
2016-05-28
Last Update Date
2017-10-25
Business Address
JESSICA PORTER COOK
393 E 2ND N
REXBURG, ID 83440-1605
Phone number: 208-359-9570
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Mailing Address
JESSICA PORTER COOK
175 STOCKHAM BLVD APT 2
RIGBY, ID 83442-1283
Phone number:
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