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Individual

GEORGE CONDIT II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3080 E GENTRY WAY, #202, MERIDIAN, ID 83642-3544
(208) 706-5287
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
IBOL MASG-121
ID

Other

Enumeration date
10/29/2014
Last updated
10/29/2014
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