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Individual

MS. KATHLEEN ALLARD LAFORTUNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
710 E 7TH ST, MOSCOW, ID 83843-3504
(208) 301-0690
Mailing address
710 E 7TH ST, MOSCOW, ID 83843-3504
(208) 301-0690

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
00005178
WA
2251P0200X
Pediatric Physical Therapist
617
ID

Other

Enumeration date
10/23/2012
Last updated
10/23/2012
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