Carla Sue Bennett, L.M.T

Individual provider Active NPI Massage Therapist · Post Falls, ID

NPI 1578029005 · NPPES record last updated Feb 20, 2019

Key facts

NPI
1578029005
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MAS-1743 (ID)
Practice address
2525 E Seltice Way
Suite C
Post Falls, ID 83854
Phone
(208) 777-7463
Fax
(208) 777-9659
NPI assigned
Feb 20, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MAS-1743IDMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MAS-1743 ID Yes

Addresses

Primary practice location

2525 E Seltice Way
Suite C
Post Falls, ID 83854

Mailing address

2525 E Seltice Way
Suite C
Post Falls, ID 83854
Phone (208) 777-7463

Other providers in Post Falls, ID

All providers in Post Falls, ID · Massage Therapist in Idaho

Sources for this page

Verify at the official NPI Registry.