# OCCUPATIONAL THERAPY PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679778286
- **Authorized official:** JANICE KYTLE SEARGENT MED OTR/L-ATP (OWNER)
- **Authorized official phone:** (208) 529-3358

## Contact information

- **Practice address:** 1820 E 17TH STREET, STE. 120, IDAHO FALLS, ID 83404-6472
- **Practice address phone:** (208) 529-3358
- **Practice address fax:** (208) 529-3382
- **Mailing address:** 1820 E 17TH STREET, STE. 120, IDAHO FALLS, ID 83404-6472
- **Mailing address phone:** (208) 529-3358
- **Mailing address fax:** (208) 529-3382

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | OT009 | ID | Yes |

## Other

- **Enumeration date:** 06/15/2007
- **Last updated:** 01/11/2012