Idaho Sport Massage LLC

NPI #1932946332 in Pocatello, Idaho

Provider Information

NPI Number
1932946332
Entity Type
Organization
Organization Name
Idaho Sport Massage LLC
Primary Specialty
Massage Therapist
Enumeration Date
Jul 11, 2024
Last Updated
Oct 24, 2024

Practice Location

Address
675 YELLOWSTONE AVE # 1
State
Idaho
ZIP Code
83201-4511
Phone
(208) 478-1488

Authorized Official

Name
MINDY CERVANTES
Title
OWNER
Phone
(435) 580-9461

Specialties & Taxonomy Codes

Specialty
Massage Therapist

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