Individual
BRANDI BECKEDAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2210 W FAIRWAY DR, COEUR D ALENE, ID 83815-8246
(208) 512-0827
Mailing address
7352 N GOVERNMENT WAY, DALTON GARDENS, ID 83815
(208) 512-0827
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-100
ID
Other
Enumeration date
02/21/2017
Last updated
02/21/2017
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