Individual
MISS BEATRICE MARGARET KENNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
1875 N LAKEWOOD DR STE 101, COEUR D ALENE, ID 83814-4928
(208) 667-3583
Mailing address
PO BOX 761, COEUR D ALENE, ID 83816-0761
(208) 416-1802
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-83
ID
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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