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1497154280
TAYLER PECK
BLACKFOOT, ID
NPI
1497154280
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: ID OTAL-1363)
Enumeration Date
2014-08-18
Last Update Date
2016-03-17
Business Address
-- TAYLER PECK COTA
7 N 600 W
BLACKFOOT, ID 83221-5533
Phone number: 208-782-2267
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Mailing Address
-- TAYLER PECK COTA
878 BROOKSIDE LN
POCATELLO, ID 83204-5039
Phone number: 208-406-7799
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