Individual
LORI MARIE MAGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, PCS
Contact information
Practice address
700 S MAIN ST, MOSCOW, ID 83843-3056
(208) 883-1522
Mailing address
700 S MAIN ST, MOSCOW, ID 83843-3056
(208) 883-1522
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT-2021
ID
Other
Enumeration date
10/16/2017
Last updated
10/16/2017
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