Provider Demographics
NPI:1568855062
Name:HINTON, LINNAEA (NCTMB / LMT)
Entity Type:Individual
Prefix:
First Name:LINNAEA
Middle Name:
Last Name:HINTON
Suffix:
Gender:F
Credentials:NCTMB / LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 73
Mailing Address - Street 2:
Mailing Address - City:RIGGINS
Mailing Address - State:ID
Mailing Address - Zip Code:83549-0073
Mailing Address - Country:US
Mailing Address - Phone:208-628-3588
Mailing Address - Fax:
Practice Address - Street 1:103 N. MAIN ST
Practice Address - Street 2:
Practice Address - City:RIGGINS
Practice Address - State:ID
Practice Address - Zip Code:83549
Practice Address - Country:US
Practice Address - Phone:208-628-3350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDMASG-1645225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist