Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath |
NPI | 1255728366 |
---|---|
Provider Name | Doty Mosford |
First Address | Waverkt, MN 55390 |
Second Address | Waverly, MN 55390 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2015 |
Last Update Date | 16/04/2015 |