Individual
JOHANNA EGGLESTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
8960 PARADISE VALLEY RD, CHINOOK, MT 59523-9387
(208) 881-8362
Mailing address
8960 PARADISE VALLEY RD, CHINOOK, MT 59523-9387
(208) 881-8362
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
ID-1459
ID
Other
Enumeration date
04/05/2018
Last updated
10/04/2021
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