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Individual

MIESHA DAWN WATKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT, NMT

Contact information

Practice address
1390 S MAPLE GROVE RD STE 200, BOISE, ID 83709-1610
(208) 672-0100
(208) 670-0200
Mailing address
2810 S ROOSEVELT ST, BOISE, ID 83705-4559
(208) 991-7560

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3735
ID

Other

Enumeration date
06/10/2021
Last updated
06/10/2021
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