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1639245939
JONATHAN CHIDESTER
REXBURG, ID
NPI
1639245939
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: ID OT-756)
Enumeration Date
2006-11-28
Last Update Date
2019-08-01
Business Address
Mr. JONATHAN CHIDESTER OTR/L
36 PROFESSIONAL PLZ STE 110
REXBURG, ID 83440-2049
Phone number: 208-359-9570
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Mailing Address
Mr. JONATHAN CHIDESTER OTR/L
4105 E 525 N
RIGBY, ID 83442-5214
Phone number: 208-705-5222
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