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NPI Code Detail

MEDICARE: KARLA BROWN OT

MEDICARE: KARLA BROWN OT
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
1174400000XSpecialistOT-443ID

General Provider Information

NPI Number : 1043469497
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARLA BROWN OT
Provider Business Mailing Address
First Line : 6855 W FAIRVIEW AVE STE 120
Second Line :
City : BOISE
State : ID
Zip : 83704-8046
Country : US
Telephone Number : 208-323-8888
Fax Number : 208-323-8889
Provider Business Practice Location Address
First Line : 6855 W FAIRVIEW AVE STE 120
Second Line :
City : BOISE
State : ID
Zip : 83704-8046
Country : US
Telephone Number : 208-323-8888
Fax Number : 208-323-8889
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2008
Last Update Date : 09/10/2008

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