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1306285598
MICAH MOEAI
POCATELLO, ID
NPI
1306285598
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: UT 8706704-4810)
Enumeration Date
2013-06-20
Last Update Date
2014-04-29
Business Address
-- MICAH MOEAI M.S., ATC
1151 HOSPITAL WAY, BLD D, STE 100
POCATELLO, ID 83202
Phone number: 808-277-3706
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Mailing Address
-- MICAH MOEAI M.S., ATC
1151 HOSPITAL WAY BLD D, STE 100
POCATELLO, ID 83201-5091
Phone number: 208-239-8010
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