Individual
SPENCER VANDENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1460 ELK CREEK DR, IDAHO FALLS, ID 83404-8237
(208) 535-1286
Mailing address
1460 ELK CREEK DR, IDAHO FALLS, ID 83404-8237
(208) 535-1286
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
07/31/2020
Last updated
07/31/2020
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