Individual
GEORGIA LEE MACHADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
603 OAK ST., KAMIAH, ID 83536
(208) 935-5616
Mailing address
PO BOX 372, KAMIAH, ID 83536-0372
(208) 935-5616
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-80
ID
Other
Enumeration date
06/08/2015
Last updated
06/08/2015
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