Individual
TAYLER PECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
7 N 600 W, BLACKFOOT, ID 83221-5533
(208) 782-2267
(208) 684-9812
Mailing address
878 BROOKSIDE LN, POCATELLO, ID 83204-5039
(208) 406-7799
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTAL-1363
ID
Other
Enumeration date
08/18/2014
Last updated
03/17/2016
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