Individual
FORREST DEAN HAMMEREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2438 MOUNTAIN VIEW DR, EMMETT, ID 83617-9581
(208) 475-1984
(208) 463-0901
Mailing address
2438 MOUNTAIN VIEW DR, EMMETT, ID 83617-9581
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
1068103
OR
225X00000X
Occupational Therapist
Primary
OT-688
ID
Other
Enumeration date
11/26/2012
Last updated
11/26/2012
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