Individual
MRS. KALYN C MAUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
2366 N RAYMOND ST, BOISE, ID 83704-7518
(208) 859-7542
Mailing address
2366 N RAYMOND ST, BOISE, ID 83704-7518
(208) 859-7542
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
110099
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NCMR3
BLUE CROSS OF IDAHO
ID
Enumeration date
05/10/2011
Last updated
07/31/2013
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