Individual
SPENCER O MAUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Mailing address
1924 ROLLINGWOOD DR, FORT COLLINS, CO 80525-1222
(970) 631-2053
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
12/09/2024
Last updated
12/09/2024
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