Individual
CARLY JEAN KAUFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3516 N GOVERNMENT WAY, COEUR D ALENE, ID 83815-8303
(208) 966-4397
Mailing address
3516 N GOVERNMENT WAY, COEUR D ALENE, ID 83815-8303
(208) 966-4397
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-390
ID
Other
Enumeration date
01/07/2014
Last updated
01/07/2014
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