Individual
LACEY DAY OSGOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
690 JOHN ADAMS PKWY, IDAHO FALLS, ID 83401-4073
(208) 525-7500
Mailing address
4983 CHIMNEY ROCK DR, IDAHO FALLS, ID 83406-8120
(208) 524-3514
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2526
AK
225X00000X
Occupational Therapist
Primary
OT665
ID
Other
Enumeration date
03/21/2013
Last updated
03/21/2013
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