Individual
MR. DAVID LEROY CRETTOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
2005 N IRONWOOD PKWY STE 216, COEUR D ALENE, ID 83814-2647
(208) 659-6459
Mailing address
212 W IRONWOOD DR STE D, COEUR D ALENE, ID 83814-1403
(208) 659-6459
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
7258
NM
225700000X
Massage Therapist
Primary
MAS-3256
ID
Other
Enumeration date
08/05/2014
Last updated
04/22/2020
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