Individual
SHARILYN M SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1125 E PINE AVE, MERIDIAN, ID 83642-5955
(208) 515-0272
Mailing address
PO BOX 654, MERIDIAN, ID 83680-0654
(208) 515-0272
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3800
ID
Other
Enumeration date
07/08/2021
Last updated
07/08/2021
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