Individual
VIVIANA BAEZA NUNEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(208) 706-5287
Mailing address
600 N SCOTNEY AVE, MERIDIAN, ID 83642-7815
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-4730
ID
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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