Most Relevant Information
Provider Data
| NPI Number: | 1003394214 |
| Provider Name: | RAEANN THORNLEY |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | MASG-269 |
Most Important Dates
| Enumeration Date: | 07/31/2018 |
| Last Updated: | 07/31/2018 |
Provider Practice Location
1625 W STATE ST
BOISE
ID
837024002
Practice Location Phone/Fax
| Phone: | 2083360017 |
| Fax: |
Provider Mailing Location
5018 S CREE WAY
BOISE
ID
837095343
Provider Mailing Phone/Fax
| Phone: | 2089019550 |
| Fax: |