Organization
MOSCOW CHARTER SCHOOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON LYNN DUNN (BUSINESS MANAGER)
(208) 883-3195
Entity
Organization
Contact information
Practice address
1723 E F STREET, MOSCOW, ID 83843-9571
(208) 883-3195
Mailing address
1723 E F ST, MOSCOW, ID 83843-9571
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
06/12/2012
Last updated
06/12/2012
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