Individual
HAILEE LYNN SEBRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 W MAIN ST, REXBURG, ID 83440-1826
(208) 356-6772
Mailing address
105 W MAIN ST, REXBURG, ID 83440-1826
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS4653
ID
Other
Enumeration date
01/26/2022
Last updated
01/26/2022
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