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1740489293
NATHAN D LONG
IDAHO FALLS, ID
NPI
1740489293
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: WA OT00004503)
Enumeration Date
2007-07-15
Last Update Date
2018-06-18
Business Address
NATHAN D LONG OTR/L
564 S WOODRUFF AVE
IDAHO FALLS, ID 83401
Phone number: 208-523-7571
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Mailing Address
NATHAN D LONG OTR/L
564 S WOODRUFF AVE
IDAHO FALLS, ID 83401
Phone number: 208-523-7571
Copy
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