NPI 1073987079

Amanda Goulart

Practitioner Massage Therapist Coeur D Alene, ID

Practice location

Address: 1042 W Mill Ave STE 104, Coeur D Alene, ID 83814-2489
Phone: (208) 659-6526
Mailing address: 2819 N Julia St APT C305, Coeur D Alene, ID 83815-5250

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence MAS-499 (ID)

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Registry record

NPI: 1073987079
Entity type: Individual
Sex (as registered): Female
NPI issued: 14 Nov 2015
Record last updated: 14 Nov 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.