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Individual

ROSE MORNINGSTAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICENSED MASSAGE THE

Contact information

Practice address
2151 W. HAYDEN AVE, HAYDEN, ID 83835
(208) 762-6772
(208) 762-6773
Mailing address
2151 W. HAYDEN AVE, HAYDEN, ID 83835
(208) 762-6772
(208) 762-6773

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MA000011941
WA
225700000X
Massage Therapist
Primary
MA00011941
WA

Other

Enumeration date
12/04/2006
Last updated
11/09/2012
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