Organization
ELEMENTS OF WELLNESS AQUATIC AND MANUAL THERAPY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DAYNA KATHLEEN WILLBANKS OTR/L (OCCUPATIONAL THERAPIST OWNER)
(208) 892-8888
Entity
Organization
Contact information
Practice address
872 TROY RD, SUITE 170, MOSCOW, ID 83843-4046
(208) 892-8888
(208) 882-8890
Mailing address
872 TROY RD, SUITE 170, MOSCOW, ID 83843-4046
(208) 892-8888
(208) 882-8890
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT-406
ID
Other
Enumeration date
01/03/2008
Last updated
01/03/2008
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