Individual
LISA HONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
3715 WOODKING DR, IDAHO FALLS, ID 83404-4720
(208) 521-3253
(208) 529-2022
Mailing address
694 MELROSE DR, IDAHO FALLS, ID 83401-3250
(208) 521-3253
(208) 529-2022
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-849
ID
Other
Enumeration date
08/29/2014
Last updated
08/29/2014
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