Individual
SHELIA NUGENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
963 S ORCHARD ST, SUITE A, BOISE, ID 83705-1939
(208) 350-0968
Mailing address
317 W GROVE ST, BOISE, ID 83702-7271
(208) 350-0968
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-423
ID
Other
Enumeration date
11/03/2014
Last updated
11/03/2014
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