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Individual

MR. DARYL OLAF JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
827 W PRAIRIE AVE, HAYDEN, ID 83835-8459
(208) 660-9378
(208) 758-8527
Mailing address
827 W PRAIRIE AVE, HAYDEN, ID 83835-8459
(208) 660-9378
(208) 758-8527

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3250
ID

Other

Enumeration date
05/31/2023
Last updated
05/31/2023
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