Individual
MRS. CANDACE LOUISE MAGNUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
106 E 3RD ST STE 1C, MOSCOW, ID 83843-2970
(208) 301-2786
Mailing address
1872 WHITE AVE, MOSCOW, ID 83843-3938
(208) 301-2786
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-1772
ID
Other
Enumeration date
08/22/2008
Last updated
03/07/2024
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