Russell, Megan
Russell, Megan is an sole proprietor health care provider with primary practice located at 430 W Iowa Ave Ste A , Nampa ID 83686-2826. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, which is considered as her primary health care specialty. Russell, Megan can be contacted via phone (208) 442-1123.Contact Information
Primary practice address
430 W Iowa Ave Ste A
Nampa ID 83686-2826
Phone: (208) 442-1123
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist | 225700000X | MASG-230 | Idaho |
Profile Details
| NPI number | 1881135259 |
|---|---|
| LBN Legal business name | Russell, Megan |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 17th, 2017 |
| Last updated | Mar 17th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881135259 | NPPES |
| Idaho | Other | MASG-230 | BUREAU OF OCCUPATIONAL LICENSES |
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