Individual
MRS. KATE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
3820 CRESTWOOD LANE, IDAHO FALLS, ID 83404
(208) 552-7700
Mailing address
3687 E 20 N, RIGBY, ID 83442
(801) 710-5588
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
7890249-4701
UT
225700000X
Massage Therapist
Primary
MAS-4453
ID
Other
Enumeration date
01/30/2013
Last updated
09/24/2021
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