GARY HOWARD WILLIS

CHUBBUCK, ID
NPI1710050414
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225X00000X Occupational Therapist
(Licence: ID  OT593)
Enumeration Date2006-11-17
Last Update Date2007-07-08
Business Address
-- GARY HOWARD WILLIS O.T.
4473 FOX CT
CHUBBUCK, ID 83202-2670
Phone number: 208-604-0800
Mailing Address
-- GARY HOWARD WILLIS O.T.
716 WYLDWOOD LN
POCATELLO, ID 83201-3644
Phone number: 208-604-0800
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