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General NPI Number Information
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NPI Number | 1457089310
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Entity Type | Individual
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Provider Name | CURTIS BRENT PEARSON OTR/L
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Gender | Male
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Dates
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Enumeration Date | 08/09/2022
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Last Update Date | 08/09/2022
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Provider Practice Location Address
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Address Line | 3372 E JENALAN
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City | POST FALLS
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State | ID
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Zip | 83854-7787
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Country | US
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Telephone | 208-262-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 145 S BENTLEY PL
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City | POST FALLS
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State | ID
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Zip | 83854-9540
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Country | US
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Telephone | 801-380-3253
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | OT-1439
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT-1439
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License Number State | ID
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