Individual
POH HENG ANTHONY TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
268 S 3RD W APT 1, REXBURG, ID 83440-2278
(208) 757-9150
Mailing address
268 S 3RD W APT 1, REXBURG, ID 83440-2278
(208) 757-9150
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
ID
Other
Enumeration date
12/26/2023
Last updated
12/26/2023
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