Doctor Name: | MS. RONNIE DALE WILLIAMS |
NPI Number: | 1174793616 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CNA , CMT |
License Number: | MX060119 |
Business Practice Address: | 7683 W Riverside Dr Boise, ID - 837146188 |
Business Phone Number: | 2088532227 |
Business Fax Number: | |
Mailing Address: | 9415 Thurman Dr Apt 7, BOISE |
State: | ID |
Postal Code: | 837141161 |
Phone Number: | 2083020378 |
Fax Number: | |
NPI Enumeration Date: | 03/11/2008 |
NPI Last Update Date: | 03/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MX060119 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |