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Ponderosa Pediatric Therapy LLC

Occupational Therapist in Post Falls, ID. Organization (NPI-2).

NPI number1053062018
StatusActive
Last updated in NPPESJan 11, 2022

Details

NPI
1053062018
Entity type
Organization (NPI-2)
Legal business name
Ponderosa Pediatric Therapy LLC
Organization subpart
No
Enumeration date
Jan 11, 2022
Certification date
Jan 11, 2022
Last updated
Jan 11, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225X00000X Occupational Therapist––Yes

Practice location

2738 N Ivy Ln
Post Falls, ID 83854-5459

Phone 360-839-1697

Mailing address

2738 N Ivy Ln
Post Falls, ID 83854-5459

Authorized official

Cortney Huff
Owner
3608391697

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