NPI 1558579979
Matthew Alan Henslee, COTA
Practice location
- Address
- 1130 Allumbaugh St, Boise, ID 83704-8700
- Phone
- (208) 854-8517
- Mailing address
- 340 Stierman Way, Eagle, ID 83616-5166
Registered specialties
Nursing Facility/Intermediate Care Facility
Primary
Registry record
- NPI
- 1558579979
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 18 May 2007
- Record last updated
- 8 Jul 2007
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.