Individual
KENDALL MINERICH LUTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2128 N 15TH ST, BOISE, ID 83702-1117
(208) 720-5112
Mailing address
2128 N 15TH ST, BOISE, ID 83702-1117
(208) 720-5112
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-2452
ID
Other
Enumeration date
04/15/2015
Last updated
04/15/2015
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