Organization
MOMMY'S OWN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ADRIANE GOYEN (OWNER)
(208) 362-6899
Entity
Organization
Contact information
Practice address
1107 E PISA ST, MERIDIAN, ID 83642-7888
(208) 362-6899
Mailing address
1107 E PISA ST, MERIDIAN, ID 83642
(208) 362-6899
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/12/2013
Last updated
03/12/2013
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