Individual
KIMBERLY KAY ENDRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
9751 N GOVERNMENT WAY STE 4, HAYDEN, ID 83835-9645
(208) 696-1330
Mailing address
PO BOX 2976, POST FALLS, ID 83877-2976
(208) 512-1792
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG2191
ID
Other
Enumeration date
02/08/2021
Last updated
02/08/2021
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