Tyler Mcomber, OTR/L | |
267 N Canyon Dr, Gooding, ID 83330-5500 | |
(208) 934-9693 | |
Not Available |
Full Name | Tyler Mcomber |
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Gender | Male |
Speciality | Occupational Therapist |
Location | 267 N Canyon Dr, Gooding, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346026747 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | 384952 (Idaho) | Primary |
Provider Name | North Canyon Medical Center Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1609046671 PECOS PAC ID: 0941371439 Enrollment ID: O20090409000304 |
Mailing Address | Practice Location Address |
---|---|
Tyler Mcomber, OTR/L 1122 Monaco St, Twin Falls, ID 83301-3137 Ph: (208) 490-4219 | Tyler Mcomber, OTR/L 267 N Canyon Dr, Gooding, ID 83330-5500 Ph: (208) 934-9693 |
Connie Vankleeck, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1695 State Highway 46, Gooding, ID 83330 Phone: 208-539-4186 | |
Lisa D Boggs, OTRL Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1220 Montana St, Gooding, ID 83330 Phone: 208-934-5601 | |
Cheyanna Christine Lierman, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 267 N. Canyon Drive, Gooding, ID 83330 Phone: 208-934-8766 |