Individual
STUART JAMES BEALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
4948 W KOOTENAI ST STE 100, BOISE, ID 83705-2002
(208) 371-1410
Mailing address
2133 S CURTIS RD, BOISE, ID 83705-3614
(208) 371-1410
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-2695
ID
Other
Enumeration date
09/16/2020
Last updated
09/16/2020
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