Kathryn Ashley Datkuliak, LMT

NPI #1922877117 in Lewiston, Idaho

Provider Information

NPI Number: 1922877117
Entity Type: Individual
Name: Kathryn Ashley Datkuliak, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: Dec 28, 2023
Last Updated: Dec 28, 2023

Practice Location

Address: 511 THAIN RD
City: Lewiston
State: Idaho
ZIP Code: 83501-5530
Phone: (208) 816-9036

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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