Individual
LEA MOOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2442 WINNE AVE, HELENA, MT 59601-4921
(913) 777-1369
Mailing address
2442 WINNE AVE, HELENA, MT 59601-4921
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/05/2022
Last updated
05/22/2024
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