Carolina Quintero
Individual provider Active NPI Massage Therapist · Pocatello, ID
NPI 1770980310 · NPPES record last updated Nov 25, 2014
Key facts
- NPI
- 1770980310
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MASG-1832 (ID)
- Practice address
- 1800 Flandro Dr
Suite 190
Pocatello, ID 83202-4912 - Phone
- (208) 233-2248
- Fax
- (208) 233-0219
- NPI assigned
- Nov 25, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MASG-1832 | ID | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MASG-1832 | ID | Yes |
Addresses
Primary practice location
1800 Flandro Dr
Suite 190
Pocatello, ID 83202-4912
Mailing address
1800 Flandro Dr
Suite 190
Pocatello, ID 83202-4912
Phone (208) 233-2248
Other providers in Pocatello, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 25, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.