Individual
TYLER KOJIMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1003 N ORCHARD ST, BOISE, ID 83706-2231
(208) 376-3113
Mailing address
1003 N ORCHARD ST, BOISE, ID 83706-2231
(208) 376-3113
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3915
ID
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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