DEAN CISCO

MOSCOW, ID
NPI1972296994
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: ID  7957)
Additional Taxonomies225100000X Physical Therapist
(Licence: OR  64348)
Enumeration Date2023-05-26
Last Update Date2023-05-26
Business Address
DEAN CISCO DPT
700 S MAIN ST
MOSCOW, ID 83843-3056
Phone number: 208-882-4511
Mailing Address
DEAN CISCO DPT
448 GREENSIDES PL
MOSCOW, ID 83843-5009
Phone number: 808-312-7407