Individual provider · Type 1 NPI

Derek Wasec Roberts, LMT

Massage Therapist · Boise, ID

NPI number 1417776345 Active

Practice location

3046 S Bown Way Ste A
Boise, ID 83706-5499

Call (208) 318-6561 Map

Mailing address

217 S Powerline Rd
Nampa, ID 83686-5440

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XMAS-4868 (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 1417776345

Derek Wasec Roberts, LMT's National Provider Identifier is 1417776345, issued on Oct 8, 2024. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Boise, ID. The record was last updated on Oct 8, 2024.