Individual
SETH ADAM FESLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
150 N 200 W, MALAD CITY, ID 83252-1239
(207) 766-3762
Mailing address
136 BANNOCK ST, MALAD CITY, ID 83252-1221
(207) 766-3762
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
6897414-4701
UT
225700000X
Massage Therapist
Primary
MAS-2376
ID
Other
Enumeration date
04/20/2015
Last updated
04/20/2015
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