Individual
MARIE ERIKSSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
700 S MAIN ST, MOSCOW, ID 83843-3056
(208) 883-1522
Mailing address
632 S LOGAN ST, MOSCOW, ID 83843-3034
(208) 882-8623
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
2048
ID
Other
Enumeration date
01/10/2007
Last updated
07/08/2007
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