Individual
MRS. M'KENZI ANN JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3345 POTOMAC WAY, IDAHO FALLS, ID 83404-4978
(208) 417-0090
(208) 417-0092
Mailing address
2162 WESTCLIFF CIR, IDAHO FALLS, ID 83402-3896
(208) 716-4110
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-2860
ID
Other
Enumeration date
03/29/2018
Last updated
03/29/2018
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