Individual
CAROLYN P BRAINARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1172 W HAYDEN AVE, HAYDEN, ID 83835-8700
(208) 762-3332
(208) 762-4268
Mailing address
1917 N LAKEWOOD DR, COEUR D ALENE, ID 83814-2634
(208) 664-8194
(208) 667-1847
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00012404
WA
Other
Enumeration date
09/28/2006
Last updated
03/06/2009
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