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Individual

ERIC DEEGEAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
1007 N ORCHARD ST, BOISE, ID 83706-2231
(210) 617-3399
Mailing address
1811 W PALOUSE ST, BOISE, ID 83705-3534
(210) 617-3399

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
110863
TX
225700000X
Massage Therapist
1611
ID

Other

Enumeration date
01/07/2015
Last updated
01/07/2015
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