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Individual

MISS AMANDA K BLANKENSHIP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMP, NCTMB

Contact information

Practice address
700 S MAIN ST, GRITMAN MEDICAL CENTER, MOSCOW, ID 83843-3056
(208) 883-6544
(208) 883-6452
Mailing address
1568 NORTHWOOD DR APT 2, MOSCOW, ID 83843-8317
(509) 330-0771

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00017159
WA

Other

Enumeration date
05/08/2007
Last updated
07/08/2007
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