Individual
MR. MICHAEL LOUNSBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
318 N LINCOLN ST, MOSCOW, ID 83843-3243
(208) 827-6127
Mailing address
318 N LINCOLN ST, MOSCOW, ID 83843-3243
(208) 827-6127
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10002373
WA
Other
Enumeration date
06/14/2005
Last updated
06/22/2021
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