Individual
TAWNYA M MOELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST
Contact information
Practice address
901 N CURTIS RD, STE 304, BOISE, ID 83706-1338
(208) 342-4263
(208) 375-0597
Mailing address
901 N CURTIS RD, STE 304, BOISE, ID 83706-1338
(208) 342-4263
(208) 375-0597
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
122512
ID
Other
Enumeration date
07/08/2015
Last updated
07/08/2015
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