Healthcare Provider Details

I. General information

NPI: 1205027182
Provider Name (Legal Business Name): LAURIE APPEL OTRL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 07/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3157 S BOWN WAY
BOISE ID
83706-5400
US

IV. Provider business mailing address

3169 S BOWN WAY
BOISE ID
83706-5400
US

V. Phone/Fax

Practice location:
  • Phone: 208-859-8670
  • Fax: 208-888-0398
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-1339
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License NumberPT-1339
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPY-1339
License Number StateID
# 4
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT-1339
License Number StateID
# 5
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-356
License Number StateID
# 6
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License NumberOT-356
License Number StateID
# 7
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT-356
License Number StateID

VIII. Authorized Official

Name: MS. LAURIE APPEL
Title or Position: PRESIDENT OWNER
Credential: OT
Phone: 208-433-9152