NPI 1013692276

Mindy Dawn Cervantes, LMT

Practitioner Massage Therapist Chubbuck, ID

Practice location

Address: 4846 Hiram Ave, Chubbuck, ID 83202-3018
Phone: (435) 580-9461

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence MAS-3001 (ID)

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Registry record

NPI: 1013692276
Entity type: Individual
Sex (as registered): Female
NPI issued: 15 Jun 2023
Record last updated: 15 Jun 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.