TERESA L GOODWIN

POCATELLO, ID
NPI1881748507
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: ID  OTA182)
Enumeration Date2007-01-22
Last Update Date2018-03-17
Business Address
TERESA L GOODWIN COTA
1957 ALVIN RICKEN DR
POCATELLO, ID 83201-2727
Phone number: 208-235-7800
Mailing Address
TERESA L GOODWIN COTA
4317 OPAL AVE TRLR 6
POCATELLO, ID 83204-2168
Phone number: 208-283-3087
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