Individual
DANIKA KRISTAN LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2305 N EAGLE CREEK LN, EAGLE, ID 83616-6819
(208) 761-0090
Mailing address
2305 N EAGLE CREEK LN, EAGLE, ID 83616-6819
(208) 761-0090
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3301
ID
225700000X
Massage Therapist
MT103802
TX
Other
Enumeration date
03/29/2018
Last updated
03/29/2018
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