Individual
ANDREA BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
560 MEMORIAL DR STE C, POCATELLO, ID 83201-4073
(208) 904-1112
(855) 319-1499
Mailing address
560 MEMORIAL DR STE C, POCATELLO, ID 83201-4073
(208) 904-1112
(855) 319-1499
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-1230
ID
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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