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Individual

KARMEN PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1529 W CRESCENT CT, MERIDIAN, ID 83646-1149
(208) 869-7579
Mailing address
1465 W DEER CREST ST, B102, MERIDIAN, ID 83646
(208) 869-7579

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-1968
ID

Other

Enumeration date
05/22/2015
Last updated
05/22/2015
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