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Individual

TANEESHA MISHEL KNIGHT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
539 S FITNESS PL STE 150, EAGLE, ID 83616-7035
(805) 750-0323
Mailing address
539 S FITNESS PL STE 150, EAGLE, ID 83616-7035
(805) 750-0323

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-4698
ID

Other

Enumeration date
11/06/2023
Last updated
11/06/2023
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