Individual
KAYLA JUDY BOHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
240 W BURNSIDE AVE STE D, CHUBBUCK, ID 83202-4703
(208) 904-1112
(866) 818-2688
Mailing address
240 W BURNSIDE AVE STE D, CHUBBUCK, ID 83202-4703
(208) 904-1112
(866) 818-2688
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-2131
ID
Other
Enumeration date
10/16/2019
Last updated
10/16/2019
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