Mr Blair William Mattson, LMT is a
Massage Therapist based in Driggs, Idaho. Mr Blair William Mattson is licensed to practice in Idaho (license number MAS909) and his current practice location is
45 E Little Ave, Driggs, Idaho. He can be reached at his office (for appointments etc.) via phone at
(208) 354-8637.
NPI number for Mr Blair William Mattson is 1629498183 and his current mailing address is Po Box 1043, Victor, Idaho. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1629498183.
Healthcare Provider's Profile
| Full Name | Mr Blair William Mattson |
|---|
| Gender | Male |
|---|
| Speciality | Massage Therapist |
|---|
| Location | 45 E Little Ave, Driggs, Idaho |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1629498183
- Provider Enumeration Date: 04/23/2014
- Last Update Date: 04/23/2014
Medical Identifiers
Medical identifiers for Mr Blair William Mattson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1629498183 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225700000X | Massage Therapist | MAS909 (Idaho) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Blair William Mattson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Blair William Mattson, LMT
Po Box 1043,
Victor, ID 83455-1031
Ph: (208) 881-4540 | Mr Blair William Mattson, LMT
45 E Little Ave,
Driggs, ID 83422-5138
Ph: (208) 354-8637 |
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