Individual
MISS BETHANY WALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2303 PARK AVE, BURLEY, ID 83318-2106
(208) 677-3073
Mailing address
2303 PARK AVE, BURLEY, ID 83318-2106
(208) 677-3073
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-1748
ID
Other
Enumeration date
03/27/2017
Last updated
03/27/2017
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