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Organization
INLANDE EMPIRE GYMNASTICS ASSOCIATION
Active
Organization
INLANDE EMPIRE GYMNASTICS ASSOCIATION
Active
Other names
Avant Coeur Gymnastics
Organization subpart
No
Provider details
NPI number
Authorized official
ASHTON NOEL UNDERDAHL (STRATEGIST)
(208) 691-0691
Entity
Organization
Contact information
Practice address
6360 N SUNSHINE ST, COEUR D ALENE, ID 83815-8699
(208) 635-5623
(208) 601-6153
Mailing address
6360 N SUNSHINE ST, COEUR D ALENE, ID 83815-8699
(208) 635-5623
(208) 601-6153
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/01/2025
Last updated
03/01/2025
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