Individual
ANGELINA THELIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
920 DION DRIVE, POCATELLO, ID 83201-3069
(208) 740-1449
Mailing address
2218 W 800 S, STERLING, ID 83210-1527
(208) 740-1449
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-93
ID
Other
Enumeration date
05/05/2015
Last updated
05/05/2015
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