Individual provider · Type 1 NPI

Carol Corinne Bradford, LMP

Massage Therapist · Moscow, ID

NPI number 1962534891 Active

Practice location

106 E 3rd St, Suite 5A
Moscow, ID 83843-2970

Call (208) 883-5856 Map

Fax (208) 289-5211

Mailing address

PO Box 89
Kendrick, ID 83537-0089

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist 225700000X024201MA00015161 (WA)
Massage Therapist Primary 225700000X034956-00 (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 1962534891

Carol Corinne Bradford, LMP's National Provider Identifier is 1962534891, issued on Mar 9, 2007. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Moscow, ID. The record was last updated on Jul 8, 2007.