Individual
LORI REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
619 S WASHINGTON ST, MOSCOW, ID 83843-3090
(208) 883-4300
(208) 883-4311
Mailing address
619 S WASHINGTON ST, MOSCOW, ID 83843-3090
(208) 883-4300
(208) 883-4311
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG - 1447
ID
Other
Enumeration date
10/29/2013
Last updated
10/29/2013
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