| Tyler Mcomber, OTR/L | |
|
267 N Canyon Dr, Gooding, ID 83330-5500 | |
| (208) 934-9693 | |
| Not Available |
| Full Name | Tyler Mcomber |
|---|---|
| Gender | Male |
| Speciality | Occupational Therapist |
| Location | 267 N Canyon Dr, Gooding, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346026747 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 384952 (Idaho) | Primary |
| Provider Name | North Canyon Medical Center Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1609046671 PECOS PAC ID: 0941371439 Enrollment ID: O20090409000304 |
| Mailing Address | Practice Location Address |
|---|---|
| Tyler Mcomber, OTR/L 1122 Monaco St, Twin Falls, ID 83301-3137 Ph: (208) 490-4219 | Tyler Mcomber, OTR/L 267 N Canyon Dr, Gooding, ID 83330-5500 Ph: (208) 934-9693 |
Connie Vankleeck, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1695 State Highway 46, Gooding, ID 83330 Phone: 208-539-4186 | |
Lisa D Boggs, OTRL Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1220 Montana St, Gooding, ID 83330 Phone: 208-934-5601 | |
Cheyanna Christine Lierman, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 267 N. Canyon Drive, Gooding, ID 83330 Phone: 208-934-8766 |