Charles Golightly
Organization Active NPI Massage Therapist · Kuna, ID
NPI 1922491513 · NPPES record last updated Mar 6, 2015
Key facts
- NPI
- 1922491513
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Massage Therapist 225700000X
- License
- MASG-1948 (ID)
- Legal business name
- CHARLES GOLIGHTLY
- Practice address
- 1797 N Azurite Dr
Kuna, ID 83634-5370 - Phone
- (208) 936-9455
- NPI assigned
- Mar 6, 2015
- Organization subpart
- No
Authorized official
- Name
- Mr. Charles Anthony Golightly
- Title
- Massage Therapist
- Phone
- (208) 936-9455
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist |
225700000X | MASG-1948 | ID | Yes |
Addresses
Primary practice location
1797 N Azurite Dr
Kuna, ID 83634-5370
Mailing address
1797 N Azurite Dr
Kuna, ID 83634-5370
Phone (208) 936-9455
Other providers in Kuna, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2015. 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.