Calico Pediatric Therapy Center, Llc

NPI 1104102375 - Speech-Language Pathologist - 235Z00000X

NPI Details
NPI 1104102375
Enumeration Date 11/01/2011
Last Updated 11/01/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name KRISTIN K KRISTIN
Position OWNER
Phone (208) 850-5804
Fax
Practice Location
1650 N HILTON ST
BOISE ID, 83706-1734, US
Phone (208) 850-5804
Fax
Business Location
4145 WILLOW CREEK RD
EAGLE ID, 83616-2505, US
Phone (208) 850-5804
Fax
Toxanomy
Taxonomy Code 235Z00000X
License State Idaho
License Number SLP-1396
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According to our database, Calico Pediatric Therapy Center, Llc NPI is 1104102375, taxonomy code is 235Z00000X and license number is SLP-1396, license state is located at Idaho. Calico Pediatric Therapy Center, Llc physically located at 1650 N Hilton St, Boise ID, 83706-1734. NPI Number 1033115704 has the healthcare provider type.

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1104102375 NPI number is provided on an as is basis without warranty of any kind. 1104102375 is maintained by the National Plan & Provider Enumeration System. The contents of Calico Pediatric Therapy Center, Llc are for informational purposes only.