Individual
MAYA LAWSON RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
875 PERIMETER DR, MOSCOW, ID 83844-9803
(208) 885-4074
Mailing address
2280 OLD PULLMAN RD, MOSCOW, ID 83843-8877
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/23/2022
Last updated
05/23/2022
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