Individual
MATTHEW DEMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1045 S ANCONA AVE STE 140, EAGLE, ID 83616-6374
(208) 352-3883
Mailing address
172 N SEVENOAKS AVE, EAGLE, ID 83616-7308
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3262
ID
Other
Enumeration date
11/25/2019
Last updated
11/25/2019
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