Shoshone Bannock Hotel & Event Center

NPI #1336872993 in Fort Hall, Idaho

Provider Information

NPI Number: 1336872993
Entity Type: Organization
Organization Name: Shoshone Bannock Hotel & Event Center
Subpart: Yes (part of a larger organization)
Parent Organization: CEDAR SPA
Primary Specialty: Massage Therapist
Enumeration Date: Jul 1, 2022
Last Updated: Jul 1, 2022

Practice Location

Address: 777 BANNOCK TRAIL
City: Fort Hall
State: Idaho
ZIP Code: 83203
Phone: (208) 238-4850

Authorized Official

Name: TAYLIA EDMO, LMT
Title: SPA MANAGER
Phone: (208) 238-4850

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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