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Individual

REBECCA L VASAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
560 MEMORIAL DR STE C, POCATELLO, ID 83201-4073
(208) 904-3311
(888) 975-1418
Mailing address
560 MEMORIAL DR STE C, POCATELLO, ID 83201-4073
(208) 904-3311

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-1776
ID

Other

Enumeration date
09/20/2017
Last updated
09/20/2017
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