Provider Demographics
NPI:1306724737
Name:MEDICINE HANDS THERAPEUTIC BODYWORK, LLC
Entity type:Organization
Organization Name:MEDICINE HANDS THERAPEUTIC BODYWORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:208-596-0014
Mailing Address - Street 1:1033 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:SAINT MARIES
Mailing Address - State:ID
Mailing Address - Zip Code:83861-1909
Mailing Address - Country:US
Mailing Address - Phone:208-596-0014
Mailing Address - Fax:
Practice Address - Street 1:805 N MAIN ST STE 108
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83843-8513
Practice Address - Country:US
Practice Address - Phone:208-596-0014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty