Individual
NOVA ORION LAYTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1315 HIGHWAY 2, SANDPOINT, ID 83864-2724
(208) 263-3211
Mailing address
PO BOX 160, LACLEDE, ID 83841-0160
(208) 304-2090
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3193
ID
Other
Enumeration date
04/30/2020
Last updated
04/30/2020
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