Individual
TARA SISTRUNK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3900 E 16TH AVE, POST FALLS, ID 83854-8925
(208) 996-1177
(208) 694-1423
Mailing address
3900 E 16TH AVE, POST FALLS, ID 83854-8925
(208) 996-1177
(208) 694-1423
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-4445
ID
Other
Enumeration date
08/12/2021
Last updated
08/12/2021
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