Individual
MARTHA BOLLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
69 RIVER RANCH RD, GARDEN VALLEY, ID 83622-5053
(208) 859-9480
Mailing address
69 RIVER RANCH RD, GARDEN VALLEY, ID 83622-5053
(208) 859-9480
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-521
ID
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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