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Individual

TAMMY JEAN COLVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT/L

Contact information

Practice address
630 ADDISON AVE W, TWIN FALLS, ID 83301-5491
(208) 737-2975
Mailing address
2343 GAREY LN, FILER, ID 83328-5543
(208) 941-1475

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-215
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OT-215
IDAHO STATE BOARD OF MEDICINE -OT
ID
Enumeration date
07/01/2008
Last updated
07/01/2008
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