Individual
MISS KASIE DAWN GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MP
Contact information
Practice address
2180 W IRONWOOD CENTER DR, COEUR D ALENE, ID 83814-2639
(208) 819-3190
Mailing address
2180 W IRONWOOD CENTER DR, COEUR D ALENE, ID 83814-2639
(208) 819-3190
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-2544
ID
Other
Enumeration date
03/03/2016
Last updated
03/03/2016
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