Individual
MIA B WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3601 N COLE RD, BOISE, ID 83704-4410
(208) 321-7348
(208) 323-7989
Mailing address
3601 N COLE RD, BOISE, ID 83704-4410
(208) 321-7348
(208) 323-7989
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1561075
ID
Other
Enumeration date
12/13/2024
Last updated
12/13/2024
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