Individual
TAYLOR KATELYN ANGUIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
185 E MALLARD DR, #140, BOISE, ID 83706-6666
(714) 904-2447
Mailing address
185 E MALLARD DR, #140, BOISE, ID 83706-6666
(714) 904-2447
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
45227
CA
Other
Enumeration date
08/04/2014
Last updated
08/04/2014
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