Individual
ERICA POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2215 ELMORE ST, POCATELLO, ID 83201-7021
(406) 850-8975
Mailing address
2215 ELMORE ST, POCATELLO, ID 83201-7021
(406) 850-8975
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-4820
ID
Other
Enumeration date
12/05/2022
Last updated
12/05/2022
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