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1578189833
DOUGLAS BIRKLAND
STAR, ID
NPI
1578189833
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: ID OTA-1085)
Enumeration Date
2020-06-23
Last Update Date
2020-06-23
Business Address
DOUGLAS BIRKLAND
12222 W BRIDGER BAY DR
STAR, ID 83669-5081
Phone number: 208-391-2773
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Mailing Address
DOUGLAS BIRKLAND
876 N CARMEN AVE
BOISE, ID 83704-9778
Phone number: 208-412-1034
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