NPI 1033551015

Tanna Susan Willis, LCMT

Practitioner Massage Therapist Boise, ID

Practice location

Address: 1529 Belmont St, Boise, ID 83725-0001
Phone: (208) 426-1459
Mailing address: 1910 University Dr, Boise, ID 83725-1351

Registered specialties (2)

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence MAS-732 (ID)

Other Massage Therapist providers in Idaho →

Student Health Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261QS1000X Licence 820290701 (ID)

Other Clinic/Center providers in Idaho →

Registry record

NPI: 1033551015
Entity type: Individual
Sex (as registered): Female
NPI issued: 19 Jul 2013
Record last updated: 19 Jul 2013

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.