Individual
ANDREW IADEROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 KENSINGTON AVE STE 100, MISSOULA, MT 59801-5670
(406) 552-1480
Mailing address
800 KENSINGTON AVE STE 100, MISSOULA, MT 59801-5670
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTP-OT-LIC-6094
MT
Other
Enumeration date
08/08/2018
Last updated
08/08/2018
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