Individual
NATALIE M THERIAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC
Contact information
Practice address
864 S HOLMES, IDAHO FALLS, ID 83401
(208) 521-1616
Mailing address
2031 DUCHESS CT, IDAHO FALLS, ID 83401-2242
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
ACU-403
ID
Other
Enumeration date
10/09/2020
Last updated
10/09/2020
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