Individual
TIFFANY R PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
760 E WARM SPRINGS AVE, BOISE, ID 83712-6476
(571) 263-5258
Mailing address
8089 S DIEGO WAY, BOISE, ID 83709-7378
(571) 263-5258
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-2762
ID
Other
Enumeration date
09/24/2017
Last updated
09/24/2017
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