Organization
PANHANDLE ANESTHESIA ASSOCIATES OF MOSCOW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY L BAUER (PRACTICE MANAGER)
(208) 691-1901
Entity
Organization
Contact information
Practice address
700 S MAIN ST, MOSCOW, ID 83843-3046
(208) 882-4511
Mailing address
PO BOX 9911, MOSCOW, ID 83843-0200
(208) 691-1901
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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