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Individual

ADRIENNE ELIZABETH WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
16150 N HIGH DESERT ST STE 112, NAMPA, ID 83687-5567
(208) 442-1123
Mailing address
700 E FAIRVIEW AVE TRLR 195, MERIDIAN, ID 83642-3325
(208) 809-4987

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-1863
ID

Other

Enumeration date
11/18/2014
Last updated
10/21/2022
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