Individual
SHANNON N COX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT, LE
Contact information
Practice address
1677 E MILES AVE, B, HAYDEN LAKE, ID 83835-9154
(208) 497-2650
Mailing address
1677 E MILES AVE, B, HAYDEN LAKE, ID 83835-9154
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MA60169177
WA
225700000X
Massage Therapist
Primary
MASG1964
ID
Other
Enumeration date
03/15/2017
Last updated
03/15/2017
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