Organization
CHARLES GOLIGHTLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES ANTHONY GOLIGHTLY (MASSAGE THERAPIST)
(208) 936-9455
Entity
Organization
Contact information
Practice address
1797 N AZURITE DR, KUNA, ID 83634-5370
(208) 936-9455
Mailing address
1797 N AZURITE DR, KUNA, ID 83634-5370
(208) 936-9455
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-1948
ID
Other
Enumeration date
03/06/2015
Last updated
03/06/2015
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