Individual
MALISA LANDALUCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
841 E FAIRVIEW AVE, SUITE 100, MERIDIAN, ID 83642-9286
(208) 283-7368
Mailing address
2271 NW 11TH AVE, MERIDIAN, ID 83646-1479
(208) 283-7368
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1052
ID
Other
Enumeration date
06/30/2014
Last updated
06/30/2014
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