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1770275984
CLAIRE E MALLICOAT
BOISE, ID
NPI
1770275984
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: ID 2743)
Enumeration Date
2023-05-24
Last Update Date
2023-05-24
Business Address
CLAIRE E MALLICOAT
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 865-223-2172
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Mailing Address
CLAIRE E MALLICOAT
7642 BORUFF RD
CORRYTON, TN 37721-3302
Phone number: 865-223-2172
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