Provider Demographics
NPI:1275878449
Name:BISCHOFF, DAVID PERRY (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:PERRY
Last Name:BISCHOFF
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 FILER AVE W
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-4533
Mailing Address - Country:US
Mailing Address - Phone:208-734-8456
Mailing Address - Fax:
Practice Address - Street 1:640 FILER AVE W
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-4533
Practice Address - Country:US
Practice Address - Phone:208-734-8456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDOT-628225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist