Individual
JOLENE ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
18355 N RAMSEY RD, RATHDRUM, ID 83858-7509
(208) 290-2409
Mailing address
18355 N RAMSEY RD, RATHDRUM, ID 83858-7509
(208) 290-2409
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00022516
WA
Other
Enumeration date
11/30/2011
Last updated
11/30/2011
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