Individual
TARA L SCHULTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
5251 E. EXCHANGE WAY, NAMPA, ID 83687
(208) 602-1230
Mailing address
P.O. BOX 1201, CALDWELL, ID 83606
(208) 602-1230
(208) 466-9104
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60175092
WA
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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