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Individual

MRS. REBECCA LYNN CUSHING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5909 W. STATE ST, BOISE, ID 83703
(208) 343-7700
(208) 331-2591
Mailing address
5909 W. STATE ST., PHYSICAL THERAPY 180, BOISE, ID 83703
(208) 343-7700
(208) 331-2591

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG2257

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MASG2257
LICENSE
ID
Enumeration date
12/30/2015
Last updated
12/30/2015
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