Individual
TYLER JAMES PINCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS, LMT
Contact information
Practice address
1110 S BOULEVARD, IDAHO FALLS, ID 83402-4033
(208) 270-3358
Mailing address
1125 HEMLOCK ST, IDAHO FALLS, ID 83401-2914
(208) 557-9365
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-2570
ID
Other
Enumeration date
05/09/2018
Last updated
05/09/2018
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