SearchIdaho224Z00000X

Kristopher Wallin, COTA/L

NPI 1205215274 · on the registry since 2015

Practice

Address
8211 W Ustick Rd
Boise, ID 83704
Phone
(208) 375-3700
Organisation at this address
Leslie Leet Llc
Peak Medical Of Boise Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
11

Registry record

Primary taxonomy
224Z00000X
224Z00000X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2015-05-24

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho