| NPI | 1538634522 |
|---|---|
| Doing Business As | MOSCOW FAMILY MEDICINE CLINIC |
| Entity Type | Organization |
| Authorized Contact | DANIELLE LYNAS CFO 208-883-2220 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2018-10-15 |