Individual
HOLLY WILKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
102 W 11TH AVE STE B, POST FALLS, ID 83854-9255
(208) 773-1868
Mailing address
1606 BOBWHITE LN, POST FALLS, ID 83854-4946
(208) 503-3949
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-2089
ID
Other
Enumeration date
06/23/2014
Last updated
06/23/2014
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