Individual
LISA MARIE PISCOPO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
4940 E MILL STATION DR, BOISE, ID 83716-8628
(303) 885-2268
Mailing address
6545 E SIGNAL ROCK DR, BOISE, ID 83716-7082
(303) 885-2268
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3665
ID
Other
Enumeration date
05/15/2020
Last updated
05/15/2020
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