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1629421201
AMBER IRENE DYSART
BOISE, ID
NPI
1629421201
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: ID OT1310)
Enumeration Date
2016-07-19
Last Update Date
2016-07-19
Business Address
Mrs. AMBER IRENE DYSART OTR/L
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-1117
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Mailing Address
Mrs. AMBER IRENE DYSART OTR/L
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-1117
Copy
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