Individual
MINDY DAWN CERVANTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4846 HIRAM AVE, CHUBBUCK, ID 83202-3018
(435) 580-9461
Mailing address
4846 HIRAM AVE, CHUBBUCK, ID 83202-3018
(435) 580-9461
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3001
ID
Other
Enumeration date
06/15/2023
Last updated
06/15/2023
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