Individual provider · Type 1 NPI

Jacquelyn Komperud, LMT

Massage Therapist · Boise, ID

NPI number 1417494022 Active

Practice location

3858 N Garden Center Way Ste 101
Boise, ID 83703-5008

Call (208) 336-0017 Map

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XMAS-2518 (ID)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1417494022

Jacquelyn Komperud, LMT's National Provider Identifier is 1417494022, issued on Jan 21, 2017. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Boise, ID. The record was last updated on Jan 21, 2017.