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1730349119
MARY LOUISE ELMORE
CALDWELL, ID
NPI
1730349119
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: ID OTA-134)
Enumeration Date
2008-06-10
Last Update Date
2008-06-10
Business Address
MARY LOUISE ELMORE COTA/L
2814 S INDIANA AVE
CALDWELL, ID 83605-5925
Phone number: 208-454-0380
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Mailing Address
MARY LOUISE ELMORE COTA/L
6330 TAHOE DR
BOISE, ID 83709-1067
Phone number: 208-841-9243
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