MR. BLAIR WILLIAM MATTSON (NPI# 1629498183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629498183 |
| Entity Type | Individual |
| Full Name | MR. BLAIR WILLIAM MATTSON |
| Credential | LMT |
| Practice Address |
45 E Little Ave Driggs ID 83422-5138 |
| Mailing Address |
Po Box 1043 Victor ID 83455-1031 |
| Practice Telephone | 2083548637 |
| Mailing Telephone | 2088814540 |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2014-04-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MAS909 | ID | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
45 E LITTLE AVE |
| City | DRIGGS |
| State | ID |
| Zip Code | 83422-5138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598310278 | Lance Ole Einerson | Physical Therapist | 440 North Main Street, Driggs, ID 83422 | 2019-08-08 |
| 1093205684 | Jennifer Lynn Mccrillis | Counselor | 1300 Arrowhead Plaza, Driggs, ID 83422 | 2018-05-18 |
| 1730636358 | Tkj, LLC | Health Educator | 1251 Arrowhead Plaza Way, Driggs, ID 83422 | 2016-09-01 |
| 1790136091 | Teton County Fire Protection Dist | Ambulance | 911 North Hwy 33, Driggs, ID 83422 | 2016-06-28 |
| 1922458942 | Candace Dayton | Social Worker | 620 Centenial Mountain Drive, Ste 12, Driggs, ID 83422 | 2016-06-21 |
| 1881092955 | Rebecca A. Park | Massage Therapist | 500 E Ski Hill Rd, Driggs, ID 83422 | 2014-12-05 |
| 1902211089 | Anna Rhea Hirnyck | Physical Therapist | 500 E Ski Hill, Drigga, ID 83422 | 2014-06-26 |
| 1982018867 | Ruby Isaly | Speech-Language Pathologist | 560 E Howard Avenue, Driggs, ID 83422 | 2014-06-18 |
| 1043633712 | Neerings Dental Inc, Dba Teton Valley Dental Center | Dentist | 235 Wallace Ave, Driggs, ID 83422 | 2014-01-30 |
| 1205261583 | Sara Helen Mckeown White | Counselor | 1300 Arrowhead Plaza Way, Driggs, ID 83422 | 2013-09-05 |
| Find all providers in zip 83422 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881092955 | Rebecca A. Park | Massage Therapist | 500 E Ski Hill Rd, Driggs, ID 83422 | 2014-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134726920 | Amber Carvajal | Massage Therapist | 5100 W Golden Ave, Rathdrum, ID 83858-6905 | 2020-10-05 |
| 1467069468 | Joanna Patricia Downer | Massage Therapist | 2596 N Stokesberry Pl Ste 130, Meridian, ID 83646-6087 | 2020-09-24 |
| 1194330720 | Unwind Spa Incorporated | Massage Therapist | 203 E Lake St, Mccall, ID 83638-3838 | 2020-09-10 |
| 1912517525 | Heidi Burk | Massage Therapist | 206 E Indiana Ave Ste 116, Coeur D Alene, ID 83814-2969 | 2020-08-07 |
| 1285243865 | Kebbie Wheeler | Massage Therapist | 625 W Pacific St Ste 5, Blackfoot, ID 83221-2034 | 2020-07-29 |
| 1588288344 | Elizabeth S Rogers-buuck | Massage Therapist | 5333 W Franklin Rd Ste C, Boise, ID 83705-1119 | 2020-06-07 |
| 1396369781 | Tina Marie Wright | Massage Therapist | 38 Mores Creek Cir, Boise, ID 83716-3026 | 2020-06-02 |
| 1902429020 | Joline Elizabeth Genay-wolf | Massage Therapist | 219 Cedar St Ste B, Sandpoint, ID 83864-1460 | 2020-05-22 |
| 1669094348 | Lisa Marie Piscopo | Massage Therapist | 4940 E Mill Station Dr, Boise, ID 83716-8628 | 2020-05-15 |
| 1790306751 | Nova Orion Layton | Massage Therapist | 1315 Highway 2, Sandpoint, ID 83864-2724 | 2020-04-30 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MR. BLAIR WILLIAM MATTSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.