Individual
MELODI BOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17601 114TH ST, LODGEPOLE, SD 57640-6520
(605) 380-5609
Mailing address
17601 114TH ST, LODGEPOLE, SD 57640-6520
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
849
CO
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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