Individual
IRIS MARIE CONRAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
35 DOGWOOD LN, SALMON, ID 83467-5083
(208) 768-7265
Mailing address
35 DOGWOOD LN, SALMON, ID 83467-5083
(208) 768-7265
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-1516
ID
Other
Enumeration date
02/26/2018
Last updated
02/26/2018
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