Individual
RAEANN THORNLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1625 W STATE ST, BOISE, ID 83702-4002
(208) 336-0017
Mailing address
5018 S CREE WAY, BOISE, ID 83709-5343
(208) 901-9550
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-269
ID
Other
Enumeration date
07/31/2018
Last updated
07/31/2018
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