Individual
DIXON MOOSEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1390 S MAPLE GROVE RD STE 200, BOISE, ID 83709-1610
(208) 672-0100
Mailing address
1390 S MAPLE GROVE RD STE 200, BOISE, ID 83709-1610
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1753
ID
Other
Enumeration date
02/09/2017
Last updated
02/09/2017
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