Individual
CHONG LUCEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11892 W CLOVER MEADOWS DR, BOISE, ID 83713-6608
(208) 863-4381
Mailing address
11892 W CLOVER MEADOWS DR, BOISE, ID 83713-6608
(208) 863-4381
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-1140
ID
Other
Enumeration date
06/23/2016
Last updated
06/23/2016
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