Provider Demographics
NPI:1700363850
Name:SCENTSATIONAL HANDS IDAHO
Entity Type:Organization
Organization Name:SCENTSATIONAL HANDS IDAHO
Other - Org Name:SCENTSATIONAL HANDS IDAHO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:BARBOUR
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:208-352-3150
Mailing Address - Street 1:412 4TH AVE S
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-3731
Mailing Address - Country:US
Mailing Address - Phone:208-352-3150
Mailing Address - Fax:
Practice Address - Street 1:412 4TH AVE S
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-3731
Practice Address - Country:US
Practice Address - Phone:208-352-3150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-22
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDMAS-4537OtherTHE IDAHO BOARD OF MASSAGE THERAPY