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1972989820
LISA DENMARK
BOISE, ID
NPI
1972989820
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: ID OTA-129)
Enumeration Date
2015-08-03
Last Update Date
2015-08-03
Business Address
LISA DENMARK COTA/L
500 W FORT ST
BOISE, ID 83702-4501
Phone number: 208-422-1000
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Mailing Address
LISA DENMARK COTA/L
500 W FORT ST
BOISE, ID 83702-4501
Phone number:
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