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Individual

DOUGLAS BIRKLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
12222 W BRIDGER BAY DR, STAR, ID 83669-5081
(208) 391-2773
Mailing address
876 N CARMEN AVE, BOISE, ID 83704-9778
(208) 412-1034

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-1085
ID

Other

Enumeration date
06/23/2020
Last updated
06/23/2020
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