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General NPI Number Information
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NPI Number | 1194239574
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Entity Type | Organization
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Legal Business Name | HALSA, LLC
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Dates
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Enumeration Date | 11/21/2017
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Last Update Date | 11/21/2017
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Provider Practice Location Address
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Address Line | 406 S ELLA AVE
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City | SANDPOINT
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State | ID
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Zip | 83864-1130
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Country | US
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Telephone | 208-521-4107
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Fax | 208-216-7446
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Provider Business Mailing Address
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Address Line | 1215 SUPERIOR ST
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City | SANDPOINT
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State | ID
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Zip | 83864-1737
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Country | US
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Telephone |
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Fax | 208-216-7446
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Authorized Official
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Title or Position | MASSAGE THERAPIST/ FOUNDING MEMBER
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Name | ERIKA FINLEY
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Credential | LMT
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Telephone | 208-521-4107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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