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1730499179
ERIC WATERS
BLACKFOOT, ID
NPI
1730499179
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: ID NBCOT 277538/NoState)
Enumeration Date
2010-10-19
Last Update Date
2013-01-22
Business Address
-- ERIC WATERS
4 N 740 W
BLACKFOOT, ID 83221-5340
Phone number: 208-684-4077
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Mailing Address
-- ERIC WATERS
PO BOX 293
BLACKFOOT, ID 83221-0293
Phone number:
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