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NPI Code Detail

MEDICARE: HARLEY RAMOS LMT

MEDICARE: HARLEY RAMOS LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMAS-3587ID

General Provider Information

NPI Number : 1053264572
Entity Type Code : Individual
Provider Name (Legal Business Name) : HARLEY RAMOS LMT
Provider Business Mailing Address
First Line : 1515 ASHMENT AVE
Second Line :
City : IDAHO FALLS
State : ID
Zip : 83404-5745
Country : US
Telephone Number : 208-881-9066
Fax Number :
Provider Business Practice Location Address
First Line : 1515 ASHMENT AVE
Second Line :
City : IDAHO FALLS
State : ID
Zip : 83404-5745
Country : US
Telephone Number : 208-881-9066
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2026
Last Update Date : 02/16/2026

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Directions to “ HARLEY RAMOS LMT” Practice Location

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