| Bounce Back Ot Llc | |
|
6070 S 2000 W, Rexburg, ID 83440-4441 | |
| (208) 356-3340 | |
| (833) 520-1454 |
| Full Name | Bounce Back Ot Llc |
|---|---|
| Type | Facility |
| Speciality | Occupational Therapist |
| Location | 6070 S 2000 W, Rexburg, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831949288 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | (* (Not Available)) | Primary |
| Provider Name | Amanda Lagerstrom |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134848286 PECOS PAC ID: 6608242623 Enrollment ID: I20221017001964 |
| Mailing Address | Practice Location Address |
|---|---|
| Bounce Back Ot Llc 6070 S 2000 W, Rexburg, ID 83440-4441 Ph: (208) 356-3340 | Bounce Back Ot Llc 6070 S 2000 W, Rexburg, ID 83440-4441 Ph: (208) 356-3340 |
Bradley Saunders, OTR-L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 450 E Main St, Rexburg, ID 83440 Phone: 208-359-6532 |
Dillon Rhet Merrill, MOTRL Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 393 E 2nd N, Rexburg, ID 83440 Phone: 208-354-9570 |
Mr. Tyson Tony Rothwell, MOTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 393 E 2nd N, Rexburg, ID 83440 Phone: 208-359-9570 Fax: 208-359-9580 |
Karen Jannette Stewart, MOTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 36 Professional Plz Ste 110, Rexburg, ID 83440 Phone: 208-359-9570 |
Jessica Porter Cook, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 393 E 2nd N, Rexburg, ID 83440 Phone: 208-359-9570 |
Mr. Bryce Parker, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 99 Tamarack Ave, Rexburg, ID 83440 Phone: 208-351-3608 |
Elizabeth David Bowman, MSOT Occupational Therapist Medicare: Medicare Enrolled Practice Location: 36 Professional Plz Ste 110, Rexburg, ID 83440 Phone: 208-359-9570 Fax: 208-359-9580 |