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Individual

MRS. TELEEA TAWNEE LUNDGREN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMT, NCTMB

Contact information

Practice address
700 S MAIN ST, GRITMAN MEDICAL CENTER, MOSCOW, ID 83843-3056
(208) 883-1522
(208) 883-6452
Mailing address
557 DEER MEADOW CT, MOSCOW, ID 83843-9389
(971) 235-4173

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
13897
OR
225700000X
Massage Therapist
Primary
MASG-1608
ID

Other

Enumeration date
09/06/2013
Last updated
09/06/2013
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