Individual
MR. BRYAN DANIEL CELIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
36 PROFESSIONAL PLZ STE 110, REXBURG, ID 83440-2049
(208) 359-9570
Mailing address
565 PIONEER RD APT 156, REXBURG, ID 83440-4987
(208) 410-5659
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Enumeration date
06/27/2024
Last updated
06/27/2024
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