Individual
MRS. CHONLADA ANANTACHOTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 S ALMON ST, SUITE 102, MOSCOW, ID 83843-2098
(208) 882-8534
Mailing address
505 INDIAN HILLS DR, APT C5, MOSCOW, ID 83843-9355
(208) 301-8969
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
06/18/2008
Last updated
06/18/2008
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