Mrs. LACEY NICOLE BEVAN L.M.T.
Individual Provider (NPI-1)
Active
Massage Therapist
Provider Information
- NPI Number
1952223356- Provider Type
- Individual Provider (NPI-1)
- Credentials
- L.M.T.
- Status
- Active
Contact & Location
- Address
- 850 E CENTER ST SUITE F, POCATELLO, ID, 832015737
- Phone
- (208) 637-9940
Specialties & Taxonomies
Massage Therapist
Primary License: ID #MASG-1967