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Individual

FRED ZACHERY NEIWERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MOT, OTR/L

Contact information

Practice address
6855 W FAIRVIEW AVE, BOISE, ID 83704-8046
(208) 323-8888
(208) 323-8889
Mailing address
5322 LINCOLNTON HWY UNIT C, THOMSON, GA 30824-5201
(509) 389-2443

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT-2018
ID
225X00000X
Occupational Therapist
Primary
OT008447
GA

Other

Enumeration date
01/13/2019
Last updated
02/07/2025
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