Individual
MS. RENEE MARIE MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
1420 E 17TH ST, SUITE E, IDAHO FALLS, ID 83404-6283
(208) 243-2668
Mailing address
1420 E 17TH ST, SUITE E, IDAHO FALLS, ID 83404-6283
(208) 243-2668
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
12/01/2009
Last updated
12/01/2009
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