Individual
ISABELLA TERI POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
12715 N 10TH AVE, HIDDEN SPRINGS, ID 83714-9333
(208) 994-9831
Mailing address
12715 N. 10TH AVE., HIDDEN SPRINGS, ID 83714
(208) 994-9831
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-2140
ID
Other
Enumeration date
02/07/2020
Last updated
02/07/2020
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