Individual
LAURA MOOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2005 IRONWOOD PKWY STE 222, COEUR D ALENE, ID 83814-2647
(208) 691-2497
(208) 635-4222
Mailing address
2005 IRONWOOD PKWY STE 222, COEUR D ALENE, ID 83814-2647
(208) 691-2497
(208) 635-4222
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00020849
WA
Other
Enumeration date
01/03/2009
Last updated
11/21/2016
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