Organization
COUNTRY CLINICAL MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EMILY MARIE SMEDLEY LMP (LICENSED MASSAGE PRACTITIONER)
(208) 755-6301
Entity
Organization
Contact information
Practice address
6101 E HIGHWAY 54 STE A, ATHOL, ID 83801-6085
(208) 755-6301
Mailing address
PO BOX 1015, 6101 E HWY 54 SUITE A, ATHOL, ID 83801-1015
(208) 755-6301
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-47
ID
Other
Enumeration date
03/13/2015
Last updated
03/13/2015
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