Individual
RORRI HENSTOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
800 MAIN ST, BUHL, ID 83316-1236
(208) 543-2005
Mailing address
2305 E 2200 N, TWIN FALLS, ID 83301-0628
(208) 329-0082
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-241
ID
Other
Enumeration date
09/15/2014
Last updated
09/15/2014
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