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AMY LEIGH FORKAN

>> Massage Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1669923892

Individual Registrant:
 AMY LEIGH FORKAN 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
301 E PARK ST.  MCCALL, ID 83638 US
Tel: 208-630-3764  Fax: --

Contact information for business:
PO BOX 975  DONNELLY, ID 83615-0975 US
Tel: 208-630-3764  Fax: --

Registration Information:
NPI: 1669923892
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225700000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Massage Therapist
IDMAS-1958

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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