Forrest Q Pecha MS, ATC, LAT, OTC

NPI 1639372709 - Specialist/Technologist, Other - 246ZS0410X

NPI Details
NPI 1639372709
Gender Male
Enumeration Date 06/07/2007
Last Updated 06/09/2011
Entity Type Individual
Active Over 9 years ago
Practice Location
1109 W MYRTLE ST
SUITE 200
BOISE ID, 83702-6970, US
Phone (208) 489-4331
Fax
Business Location
12664 N 13TH AVE
BOISE ID, 83714-5061, US
Phone (208) 908-1236
Fax
Toxanomy
Taxonomy Code 246ZS0410X
License State Georgia
License Number 02 5855
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According to our database, Forrest Q Pecha MS, ATC, LAT, OTC NPI is 1639372709, taxonomy code is 246ZS0410X and license number is 02 5855, license state is located at Georgia. Forrest Q Pecha MS, ATC, LAT, OTC physically located at 1109 W Myrtle St, Boise ID, 83702-6970. NPI Number Forrest Q Pecha MS, ATC, LAT, OTC has the Individual type.

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1639372709 NPI number is provided on an as is basis without warranty of any kind. 1639372709 is maintained by the National Plan & Provider Enumeration System. The contents of Forrest Q Pecha MS, ATC, LAT, OTC are for informational purposes only.