Individual
MATTHEW ALEX NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, CMA, MFA
Contact information
Practice address
760 E WARM SPRINGS AVE, STE Z, BOISE, ID 83712-6476
(208) 985-0331
Mailing address
2441 W MENLO DR, BOISE, ID 83702-0322
(208) 985-0331
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-2851
ID
Other
Enumeration date
01/16/2017
Last updated
01/16/2017
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