Individual
MONALI ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
821 21ST AVE, LEWISTON, ID 83501-6389
(208) 799-3422
Mailing address
1952 E 7000 S, SALT LAKE CITY, UT 84121-6877
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2529
ID
225100000X
Physical Therapist
PT60086514
WA
Other
Enumeration date
01/28/2015
Last updated
01/28/2015
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