Organization
NORTH IDAHO MOBILE OT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIP TAYLOR PT (FOUNDER)
(208) 819-2554
Entity
Organization
Contact information
Practice address
5925 W RIVERVIEW DR, COEUR D ALENE, ID 83814-7705
(208) 819-2554
Mailing address
5925 W RIVERVIEW DR, COEUR D ALENE, ID 83814-7705
(208) 819-2554
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
01/13/2023
Last updated
01/13/2023
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