Individual
MR. ADAM DOUGLAS DELUCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1104 N 4TH ST UNIT B, COEUR D ALENE, ID 83814-3217
(208) 292-4873
Mailing address
1104 N 4TH ST UNIT B, COEUR D ALENE, ID 83814-3217
(208) 292-4873
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3813
ID
Other
Enumeration date
03/14/2022
Last updated
03/14/2022
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