NPI 1023489218

Deneb Edwards, MT

Practitioner Massage Therapist Burley, ID

Practice location

Address: 1315 Oakley Ave, Burley, ID 83318-1833
Phone: (208) 244-2585
Mailing address: 621 Doggett Dr, Heyburn, ID 83336-9639

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence MASG-1932 (ID)

Other Massage Therapist providers in Idaho →

Registry record

NPI: 1023489218
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Oct 2015
Record last updated: 13 Oct 2015

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.