Individual
MRS. IONE ELLOWENE STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
421 E COEUR DALENE AVE, SUITE L2, COEUR D ALENE, ID 83814-1704
(208) 704-8052
Mailing address
421 COEUR D ALENE AVE, SUITE L2, COEUR D ALENE, ID 83814
(208) 704-8052
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
28741
ID
Other
Enumeration date
06/09/2008
Last updated
06/09/2008
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