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Individual

MR. ROGER JAMES BURT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
1555 N MOONSTONE ST, POST FALLS, ID 83854-6176
(208) 964-1585
Mailing address
1555 N MOONSTONE ST, POST FALLS, ID 83854-6176
(208) 964-1585

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MA60623287
WA
225700000X
Massage Therapist
Primary
MAS4807
ID

Other

Enumeration date
01/20/2016
Last updated
10/08/2024
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