Individual
MR. TODD WILLIAM MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
815 RIVER ST, PAYETTE, ID 83661-2179
(208) 642-8859
Mailing address
815 RIVER ST, PAYETTE, ID 83661-2179
(208) 642-8859
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10934
OR
Other
Enumeration date
07/13/2008
Last updated
07/13/2008
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