Individual
MARSHALL BLAKE COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1550 S CLOVERDALE RD STE 103, BOISE, ID 83709-1128
(208) 867-5222
Mailing address
11761 PENOBSCOT ST, CALDWELL, ID 83605-5777
(208) 867-5222
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3946
ID
Other
Enumeration date
08/03/2021
Last updated
08/03/2021
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