KENNETH WAYNE SMITH

BOISE, ID
NPI1740563634
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: ID  OTA-1091)
Enumeration Date2011-09-27
Last Update Date2011-09-27
Business Address
-- KENNETH WAYNE SMITH COTA/L
12046 W SPRING RIVER CT
BOISE, ID 83709-5160
Phone number: 208-968-4302
Mailing Address
-- KENNETH WAYNE SMITH COTA/L
12046 W SPRING RIVER CT
BOISE, ID 83709-5160
Phone number: 208-968-4302
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