Individual
DOROTHY PLAZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
700 S MAIN ST, MOSCOW, ID 83843-3056
(208) 883-6341
Mailing address
916 E 7TH ST, MOSCOW, ID 83843-3709
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
50282
ID
Other
Enumeration date
09/18/2017
Last updated
09/18/2017
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