Individual
KEVIN DAGOSTINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, OTR/L
Contact information
Practice address
600 N ROBBINS RD, BOISE, ID 83702-4565
(208) 489-4444
Mailing address
600 N ROBBINS RD, BOISE, ID 83702-4565
(208) 489-4444
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-1198
ID
Other
Enumeration date
02/11/2014
Last updated
02/11/2014
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