Individual
JULIE PAINTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT
Contact information
Practice address
700 N 2ND ST, ASHTON, ID 83420-5105
(208) 359-9570
Mailing address
36 PROFESSIONAL PLZ STE 110, REXBURG, ID 83440-2049
(208) 359-9570
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-2170
ID
225X00000X
Occupational Therapist
OTP-OT-LIC-3328
MT
Other
Enumeration date
09/13/2024
Last updated
09/13/2024
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