Individual
SUSAN H SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T
Contact information
Practice address
10790 W LA GRANGE ST, BOISE, ID 83709-6264
(208) 863-3364
Mailing address
10790 W LA GRANGE ST, BOISE, ID 83709-6264
(208) 863-3364
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-852
ID
Other
Enumeration date
10/05/2014
Last updated
10/05/2014
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