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1821875287
MCKENZIE J MOON
IDAHO FALLS, ID
NPI
1821875287
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: ID OTA2800)
Enumeration Date
2023-09-11
Last Update Date
2023-09-11
Business Address
MCKENZIE J MOON
1460 ELK CREEK DR
IDAHO FALLS, ID 83404-8237
Phone number: 208-535-1286
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Mailing Address
MCKENZIE J MOON
1460 ELK CREEK DR
IDAHO FALLS, ID 83404-8237
Phone number:
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