Individual
MARK ALLEN EAMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
510 E 17TH ST, SUITE 400, IDAHO FALLS, ID 83404-6154
(208) 589-0807
(208) 542-9577
Mailing address
9402 S MARSH CREEK RD, MCCAMMON, ID 83250-1695
(208) 254-9942
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-100
ID
Other
Enumeration date
01/04/2007
Last updated
07/08/2007
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