Individual
KATHRYN TESSENDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
1401 W BIZTOWN LOOP, HAYDEN, ID 83835-5113
(208) 762-3660
Mailing address
3977 W LENNOX LOOP, COEUR D ALENE, ID 83815-8713
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-1392
ID
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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