| NPI | 1659429405 |
|---|---|
| Doing Business As | MOSCOW MOUNTAIN SPORT AND PHYSICAL THERAPY |
| Entity Type | Organization |
| Authorized Contact | KELLY ISAKSON Owner 208-882-1426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2007-08-17 |