LEUNG S TAI

REXBURG, ID
NPI1639414287
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: ID  OTA-1064)
Enumeration Date2012-12-09
Last Update Date2012-12-09
Business Address
-- LEUNG S TAI COTA
634 TREJO ST
REXBURG, ID 83440-2579
Phone number: 208-761-0252
Mailing Address
-- LEUNG S TAI COTA
634 TREJO ST
REXBURG, ID 83440-2579
Phone number: 208-761-0252
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