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1407940497
MICHAEL VICTOR NOWACK
SPIRIT LAKE, ID
NPI
1407940497
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: WA PT00009579)
Enumeration Date
2006-10-03
Last Update Date
2015-11-30
Business Address
-- MICHAEL VICTOR NOWACK D.P.T
6186 W MAINE
SPIRIT LAKE, ID 83869
Phone number: 208-623-6717
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Mailing Address
-- MICHAEL VICTOR NOWACK D.P.T
PO BOX 3482
POST FALLS, ID 83877-3482
Phone number: 208-209-6170
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