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1740990118
JEREMY ETHAN FIRSTENBERG
IDAHO FALLS, ID
NPI
1740990118
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225XP0200X Occupational Therapist, Pediatrics
(Licence: ID OT-2661)
Enumeration Date
2022-11-28
Last Update Date
2022-11-28
Business Address
JEREMY ETHAN FIRSTENBERG OTR/L
1460 ELK CREEK DR
IDAHO FALLS, ID 83404-8237
Phone number: 208-535-1286
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Mailing Address
JEREMY ETHAN FIRSTENBERG OTR/L
1460 ELK CREEK DR
IDAHO FALLS, ID 83404-8237
Phone number:
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