Organization
MOSCOW MOUNTAIN ANESTHESIA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD WINTERBOTTOM CRNA (PRESIDENT)
(208) 883-1500
Entity
Organization
Contact information
Practice address
2300 W A ST, MOSCOW, ID 83843-4038
(208) 883-1500
(208) 882-7701
Mailing address
2300 W A ST, MOSCOW, ID 83843-4038
(208) 883-1500
(208) 882-7701
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
03/20/2017
Last updated
02/13/2024
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