Checotah Carroll

NPI #1801394796 in Rexburg, Idaho

Provider Information

NPI Number: 1801394796
Entity Type: Individual
Name: Checotah Carroll
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Enumeration Date: Jan 25, 2018
Last Updated: Jan 25, 2018

Practice Location

Address: 32 CARLSON AVE
City: Rexburg
State: Idaho
ZIP Code: 83440-1914
Phone: (208) 557-3516

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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