Individual
HEATHER RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1013 LAKE ST STE 100, SANDPOINT, ID 83864-5002
(208) 597-7597
Mailing address
34 SKYRANCH DR, SANDPOINT, ID 83864-7524
(360) 567-9768
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-4722
ID
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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