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General NPI Number Information
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NPI Number | 1316006182
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Entity Type | Organization
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Legal Business Name | NORTH IDAHO HAND REHABILITATION, PLLC
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 05/05/2010
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Provider Practice Location Address
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Address Line | 943 W IRONWOOD DR STE 100
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City | COEUR D ALENE
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State | ID
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Zip | 83814-4904
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Country | US
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Telephone | 208-765-3600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3482
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City | POST FALLS
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State | ID
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Zip | 83877-3482
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER THERAPIST
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Name | ROBERT SWIDER
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Credential | OTR, CHT
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Telephone | 208-765-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number | OT-705
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License Number State | ID
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