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NPI Code Detail

MEDICARE: KAMBER DAWN SPANGLER MOTR/L

MEDICARE: KAMBER DAWN SPANGLER MOTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOTL-1134ID

General Provider Information

NPI Number : 1285994194
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAMBER DAWN SPANGLER MOTR/L
Provider Business Mailing Address
First Line : 8364 W BANJO DR
Second Line :
City : BOISE
State : ID
Zip : 83709-6482
Country : US
Telephone Number : 208-240-4454
Fax Number :
Provider Business Practice Location Address
First Line : 7211 W FRANKLIN RD
Second Line :
City : BOISE
State : ID
Zip : 83709-0926
Country : US
Telephone Number : 208-375-4200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2012
Last Update Date : 05/24/2012

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