Individual
ELIZABETH ADA SHAKESPEARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
760 E WARM SPRINGS AVE, STE G, BOISE, ID 83712-6476
(208) 901-0511
Mailing address
760 E WARM SPRINGS AVE STE G, BOISE, ID 83712-6459
(208) 901-0511
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-2334
ID
Other
Enumeration date
04/04/2016
Last updated
04/04/2016
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