Individual
ELIZABETH S ROGERS-BUUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5333 W FRANKLIN RD STE C, BOISE, ID 83705-1119
(208) 794-0593
Mailing address
16840 N YORKSHIRE LN, NAMPA, ID 83687-9236
(208) 794-0593
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-1681
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MASG-1681
REIMBURSEMENT
ID
Enumeration date
06/07/2020
Last updated
06/07/2020
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