NPI 1053145110

Kevin Blair, LMTPTA

Practitioner Massage Therapist Idaho Falls, ID

Practice location

Address: 3155 Channing Way, Idaho Falls, ID 83404-7874
Phone: (208) 557-8962
Mailing address: 440 E 24th St, Idaho Falls, ID 83404-6946

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence MAS-4984 (ID)

Other Massage Therapist providers in Idaho →

Registry record

NPI: 1053145110
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Aug 2024
Record last updated: 29 Aug 2024

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.