Individual
SUSAN R STOCKTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNMT, LMT
Contact information
Practice address
575 E PARKCENTER BLVD STE 190, BOISE, ID 83706-6773
(208) 407-7244
Mailing address
13 RED HORSE RIDGE RD, BOISE, ID 83716-3125
(208) 407-7244
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MA44626
FL
225700000X
Massage Therapist
Primary
MASG-218
ID
225700000X
Massage Therapist
MT040994
TX
Other
Enumeration date
07/06/2006
Last updated
04/14/2024
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