IndividualActive
Diego Maldonado Quezada
NPI 1679266308 · Athletic Trainer · Moscow, ID
Provider details
- NPI number
- 1679266308
- Entity type
- Individual
- Primary specialty
- Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Speech, Language and Hearing Service Providers
Student, Health Care
Practice location
875 Perimeter Dr
Moscow, ID 83844-9803
Phone: (208) 885-6111
Approximate (ZIP-level) locationGet directions
Mailing address
604 W a St Apt B
Moscow, ID 83843-2198
Registry dates
- Enumerated
- 2023-05-30
- Last updated
- 2025-08-02
- Certified
- 2025-08-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.