Individual
MR. ANSON P TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
1351 W PINE AVE, MERIDIAN, ID 83642-5031
(208) 888-7049
Mailing address
2617 S LEADVILLE AVE, BOISE, ID 83706-4735
(208) 724-0356
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 151
ID
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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