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2707 Garrity Blvd #3 Nampa ID 83687 | |
| (208) 367-4422 | |
| (208) 442-2358 |
| Full Name | |
|---|---|
| Speciality | Occupational Therapist |
| Location | 2707 Garrity Blvd, Nampa, Idaho |
| Authorized Official Name and Position | Brian Lannie Checketts (CFO) |
| Authorized Official Contact | 2083677347 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
901 N Curtis Rd #204 Boise ID 83706-1338 Ph: (208) 367-8950 | 2707 Garrity Blvd #3 Nampa ID 83687 Ph: (208) 367-4422 |
| NPI Number | 1831318021 |
|---|---|
| Provider Enumeration Date | 04/25/2007 |
| Last Update Date | 01/24/2023 |
| Certification Date | 01/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831318021 | NPI | - | NPPES |
| 002265701 | Medicaid | ID |
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