Individual
KIM RENEE EVENSVOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
HAYDEN YOGA & MASSAGE, 181 W. COMMERCE DRIVE, HAYDEN, ID 83835
(208) 696-1330
Mailing address
16900 N LOLO DR, RATHDRUM, ID 83858-7316
(406) 750-1934
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3558
ID
Other
Enumeration date
06/05/2024
Last updated
06/05/2024
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