Individual
MISHA DAWN MOONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC, DIPL. O.M
Contact information
Practice address
203 W FORT ST, BOISE, ID 83702-4528
(224) 388-0810
Mailing address
816 N 10TH ST, BOISE, ID 83702-5422
(224) 388-0810
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
ACU-310
ID
Other
Enumeration date
04/13/2015
Last updated
04/13/2015
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