Individual
MR. CODY A HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2007 E QUAIL RUN RD, STE 2, EMMETT, ID 83617
(208) 365-2024
Mailing address
4004 SANDY AVE, EMMETT, ID 83617
(208) 365-2024
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-5277
ID
Other
Enumeration date
02/13/2024
Last updated
02/13/2024
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