Most Relevant Information
Provider Data
| NPI Number: | 1003279357 |
| Provider Name: | KYLEE MICHELLE PERMANN OTD, OTR/L |
| Entity Type: | Individual |
| Taxonomy Code: | 225XH1200X |
| Specialty: | Occupational Therapist |
| License Number: | 1559 |
Most Important Dates
| Enumeration Date: | 04/04/2016 |
| Last Updated: | 04/04/2016 |
Provider Practice Location
560 MEMORIAL DR STE B
POCATELLO
ID
832014073
Practice Location Phone/Fax
| Phone: | 2084780258 |
| Fax: | 2082697336 |
Provider Mailing Location
560 MEMORIAL DR STE B
POCATELLO
ID
832014073
Provider Mailing Phone/Fax
| Phone: | 2084780258 |
| Fax: | 2082697336 |