Individual
MARK ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1978 ADDISON AVE E, TWIN FALLS, ID 83301-5304
(208) 733-2656
Mailing address
1978 ADDISON AVE E, TWIN FALLS, ID 83301-5304
(208) 733-2656
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3725
ID
Other
Enumeration date
06/12/2019
Last updated
06/12/2019
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