Individual
AMANDA SUE CHRISTIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
316 N MAIN ST, MOSCOW, ID 83843-2629
(208) 892-0318
Mailing address
2990 E PALOUSE RIVER DR TRLR 321, MOSCOW, ID 83843-8869
(208) 596-7800
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-4993
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MAS-4993
MASSAGE LICENSE
ID
Enumeration date
02/09/2023
Last updated
02/09/2023
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