Provider Demographics
NPI:1457881138
Name:DAYTON, LINDA M (LMT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:DAYTON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7226 CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83687-8302
Mailing Address - Country:US
Mailing Address - Phone:208-697-9607
Mailing Address - Fax:
Practice Address - Street 1:40 W FRANKLIN RD STE A
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-2992
Practice Address - Country:US
Practice Address - Phone:208-697-9607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-15
Last Update Date:2017-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDMAS22225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist