Individual
COLEMAN JOSHUA LAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
100 HOSPITAL DR #104, KETCHUM, ID 83340
(208) 727-8253
(208) 727-8258
Mailing address
100 HOSPITAL DR #104, KETCHUM, ID 83340
(208) 727-8253
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2317
ID
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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