Individual
MRS. AMY RADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2060 E 25TH ST, IDAHO FALLS, ID 83404-6490
(208) 821-2105
(208) 523-2864
Mailing address
2060 E 25TH ST, IDAHO FALLS, ID 83404-6490
(208) 821-2105
(208) 523-2864
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-877
ID
Other
Enumeration date
01/09/2015
Last updated
01/09/2015
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