Doctor Name: | MRS. IONE ELLOWENE STAFFORD |
NPI Number: | 1447419908 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | 28741 |
Business Practice Address: | 421 E Coeur Dalene Ave Suite L2 Coeur D Alene, ID - 838141704 |
Business Phone Number: | 2087048052 |
Business Fax Number: | |
Mailing Address: | 421 Coeur D Alene Ave, Suite L2 COEUR D ALENE |
State: | ID |
Postal Code: | 83814 |
Phone Number: | 2087048052 |
Fax Number: | |
NPI Enumeration Date: | 06/09/2008 |
NPI Last Update Date: | 06/09/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 28741 |
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. |