Individual
KRISTINE ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
539 S. FITNESS PL., #150, EAGLE, ID 83616
(805) 750-0323
Mailing address
539 S. FITNESS PL., #150, EAGLE, ID 83616
(805) 750-0323
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-216
ID
Other
Enumeration date
10/29/2024
Last updated
10/29/2024
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