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1891050068
MARK LEE MOSS
BOISE, ID
NPI
1891050068
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: ID PT 3018)
Enumeration Date
2012-07-12
Last Update Date
2014-10-10
Business Address
-- MARK LEE MOSS P.T.
390 E PARKCENTER BLVD SUITE 130
BOISE, ID 83706-6662
Phone number: 208-433-9211
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Mailing Address
-- MARK LEE MOSS P.T.
16083 SW UPPER BOONES FERRY RD SUITE 300
TIGARD, OR 97224-7736
Phone number: 800-219-8835
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