Organization
PALOUSE RIDGE OCCUPATIONAL THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA BLACK (OCCUPATIONAL THERAPIST)
(208) 669-3186
Entity
Organization
Contact information
Practice address
510 ELM ST, POTLATCH, ID 83855
(208) 669-3186
(208) 747-0782
Mailing address
1026 GRANGE PARK RD, PRINCETON, ID 83857-5500
(208) 669-3186
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
04/13/2022
Last updated
04/13/2022
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