Most Relevant Information
Provider Data
| NPI Number: | 1003689449 |
| Provider Name: | TANEESHA MISHEL KNIGHT |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | MAS-4698 |
Most Important Dates
| Enumeration Date: | 11/06/2023 |
| Last Updated: | 11/06/2023 |
Provider Practice Location
539 S FITNESS PL STE 150
EAGLE
ID
836167035
Practice Location Phone/Fax
| Phone: | 8057500323 |
| Fax: |
Provider Mailing Location
539 S FITNESS PL STE 150
EAGLE
ID
836167035
Provider Mailing Phone/Fax
| Phone: | 8057500323 |
| Fax: |