Individual
ANTHONY ARTHUR WILBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
150 E RIVERSIDE DR, SUITE 100, EAGLE, ID 83616-6087
(208) 938-3511
Mailing address
150 E RIVERSIDE DR, SUITE 100, EAGLE, ID 83616-6087
(208) 938-3511
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-2499
ID
Other
Enumeration date
07/17/2015
Last updated
07/17/2015
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