Individual
GLORIA STAR JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MANUAL THERAPIST
Contact information
Practice address
50 MAIN ST, PRIEST RIVER, ID 83856-6758
(505) 402-1885
Mailing address
50 MAIN ST, PRIEST RIVER, ID 83856-6758
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-291
ID
Other
Enumeration date
04/01/2022
Last updated
04/01/2022
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