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 |