Individual
BRICE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSAT, LAT, ATC, CSCS
Contact information
Practice address
777 HOSPITAL WAY, POCATELLO, ID 83201-5175
(208) 242-8650
Mailing address
1412 SARATOGA ST, POCATELLO, ID 83201-2253
(208) 242-8650
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-657
ID
Other
Enumeration date
04/05/2018
Last updated
09/27/2024
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