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Individual

AMBER DAWN WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
430 W IOWA AVE STE A, NAMPA, ID 83686-2826
(208) 442-1123
Mailing address
430 W IOWA AVE STE A, NAMPA, ID 83686-2826
(208) 442-1123

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-1305
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MASG-1305
MT
ID
Enumeration date
11/27/2018
Last updated
11/27/2018
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