Individual
RHONDA RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
1880 E 17TH ST, IDAHO FALLS, ID 83404-6468
(208) 523-0121
(208) 529-0001
Mailing address
1880 E 17TH ST, IDAHO FALLS, ID 83404-6468
(208) 523-0121
(208) 529-0001
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG2229
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MSG2229
BUREAU OF OCCUPATIONAL LISCENSE
ID
Enumeration date
08/12/2015
Last updated
08/12/2015
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