Organization
IDAHO MEDICAL MASSAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER MICHELLE KOOMPIN LMT (OWNER, MEDICAL MASSAGE PRACTITIONER)
(208) 339-3655
Entity
Organization
Contact information
Practice address
809 W CEDAR ST, POCATELLO, ID 83201-6139
(208) 244-0941
Mailing address
809 W CEDAR ST, POCATELLO, ID 83201-6139
(208) 244-0941
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
11/06/2025
Last updated
11/06/2025
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