NICHOLAS RAY RIVELAND

EAGLE, ID
NPI1871109728
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225XP0200X Occupational Therapist, Pediatrics
(Licence: ID  2273)
Enumeration Date2020-09-16
Last Update Date2020-09-16
Business Address
Mr. NICHOLAS RAY RIVELAND OTR/L
449 S FITNESS PL
EAGLE, ID 83616-6828
Phone number: 208-957-6301
Mailing Address
Mr. NICHOLAS RAY RIVELAND OTR/L
7458 W SAXTON DR APT 202
BOISE, ID 83714-1320
Phone number: 701-330-8842