Individual
ADRIANNA REGALADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2308 N COLE RD STE H, BOISE, ID 83704-7361
(208) 697-3840
Mailing address
86 S PEPPERMINT DR, NAMPA, ID 83687-9129
(208) 697-3840
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3235
ID
Other
Enumeration date
03/03/2020
Last updated
03/03/2020
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