Individual
VALERIE LOUISE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.T.C., L.M.T.
Contact information
Practice address
1100 N COLE RD, BOISE, ID 83704-8644
(208) 375-7500
Mailing address
4245 S PALATINO AVE, MERIDIAN, ID 83642-9265
(520) 730-5512
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
ATR-LAT-LIC-1007
MT
225700000X
Massage Therapist
Primary
MAS-2635
ID
Other
Enumeration date
09/09/2015
Last updated
09/09/2015
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