Individual
KIMBERLY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMMP
Contact information
Practice address
3271 N MILWAUKEE ST, BOISE, ID 83704-4425
(208) 629-5374
Mailing address
1553 N MILWAUKEE ST # 132, BOISE, ID 83704-8471
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-1898
ID
Other
Enumeration date
07/11/2018
Last updated
07/11/2018
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