Individual
KIRSTEN A DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1995 E 17TH ST, SUITE 2, IDAHO FALLS, ID 83404-6493
(208) 529-2352
Mailing address
1995 E 17TH ST, SUITE 2, IDAHO FALLS, ID 83404-6493
(208) 529-2352
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
602981393
WA
225700000X
Massage Therapist
Primary
—
ID
Other
Enumeration date
09/29/2010
Last updated
11/09/2012
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