Individual
MS. KIM RENEE EDMONDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
202 N 3RD ST, COEUR D ALENE, ID 83814-2807
(707) 337-7787
Mailing address
202 N 3RD ST, COEUR D ALENE, ID 83814-2807
(707) 337-7787
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-1688
ID
Other
Enumeration date
08/11/2015
Last updated
08/11/2015
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