Individual
MRS. IVANNA TALI ROTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1311 E CENTRAL DR, MERIDIAN, ID 83642-7991
(208) 282-4636
Mailing address
2832 E RED FIR CT, BOISE, ID 83716-7102
(208) 761-8330
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AUD-6054
ID
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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