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Individual

MR. DEAN DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3226 8TH ST APT J, LEWISTON, ID 83501-4836
(208) 305-1964
Mailing address
3226 8TH ST APT J, LEWISTON, ID 83501-4836
(208) 305-1964

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
06357783
ID

Other

Enumeration date
06/12/2013
Last updated
06/12/2013
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