NPI 1033542196

William David Pentecost, COTA

Practitioner Occupational Therapy Assistant Weiser, ID

Practice location

Address: 331 E Park St, Weiser, ID 83672-2053
Phone: (208) 549-0206
Fax: (208) 549-0536
Mailing address: 1486 W Colville CT, Eagle, ID 83616-4869

Registered specialties

Occupational Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Z00000X Licence OTA-168 (ID)

Other Occupational Therapy Assistant providers in Idaho →

Registry record

NPI: 1033542196
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Aug 2013
Record last updated: 13 Aug 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.