Individual
PHILLIP JOSEPH MOYNIHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2833 BROADWAY ST, BOULDER, CO 80304-3544
(303) 449-2217
Mailing address
PO BOX 1742, NEDERLAND, CO 80466-1742
(303) 258-3480
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/30/2007
Last updated
07/08/2007
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