| NPI | 1932946332 |
|---|---|
| Doing Business As | IDAHO SPORT MASSAGE |
| Entity Type | Organization |
| Authorized Contact | MINDY CERVANTES Owner 435-580-9461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225700000X Massage Therapist |
| Enumeration Date | 2024-07-11 |
| Last Update Date | 2024-10-24 |