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Individual

ADAM MOON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BS

Contact information

Practice address
615 HOOPES AVE, IDAHO FALLS, ID 83401-6106
(208) 542-0352
Mailing address
615 HOOPES AVE, IDAHO FALLS, ID 83401-6106
(208) 542-0352

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
08/06/2024
Last updated
08/06/2024
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