Individual
MALLORY SUE BARBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
12598 W MEDALIST DR, BOISE, ID 83709-6500
(208) 954-3479
Mailing address
12598 W MEDALIST DR, BOISE, ID 83709-6500
(208) 954-3479
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/20/2019
Last updated
05/20/2019
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