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Individual

ROXANNE MASLIKOWSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
875 PERIMETER DR, MOSCOW, ID 83844-9803
(219) 308-6853
Mailing address
1247 LAKEVIEW AVE, WHITING, IN 46394-1918

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
AT-665
ID
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
AT-665
ID

Other

Enumeration date
08/03/2018
Last updated
08/03/2018
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