Organization
RENEW YOU THERAPIES & BEAUTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TESLA HEIDI GILLESPIE LMT (OWNER)
(208) 546-9355
Entity
Organization
Contact information
Practice address
1111 S ORCHARD ST STE 160, BOISE, ID 83705-1977
(208) 546-9355
Mailing address
1111 S ORCHARD ST STE 160, BOISE, ID 83705-1977
(208) 546-9355
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-303
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A0002158
MASSAGE
ID
Enumeration date
09/18/2014
Last updated
09/18/2014
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