Healthsource Of Moses Lake

NPI 1003212895 - Clinic/Center - 261Q00000X

NPI Details
NPI 1003212895
Enumeration Date 11/06/2014
Last Updated 11/06/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name GREGG MOYLE GREGG
Position PRESIDENT
Phone (509) 765-0638
Fax (509) 765-3891
Practice Location
420 W 3RD AVE
MOSES LAKE WA, 98837-1908, US
Phone (509) 765-0638
Fax (509) 765-3891
Business Location
420 W 3RD AVE
MOSES LAKE WA, 98837-1908, US
Phone (509) 765-0638
Fax (509) 765-3891
Toxanomy
Taxonomy Code 261Q00000X
License State Washington
License Number CH00003167
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According to our database, Healthsource Of Moses Lake NPI is 1003212895, taxonomy code is 261Q00000X and license number is CH00003167, license state is located at Washington. Healthsource Of Moses Lake physically located at 420 W 3rd Ave, Moses Lake WA, 98837-1908. NPI Number 1033115704 has the healthcare provider type.

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1003212895 NPI number is provided on an as is basis without warranty of any kind. 1003212895 is maintained by the National Plan & Provider Enumeration System. The contents of Healthsource Of Moses Lake are for informational purposes only.