Individual
FERNANDO SANTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 N 16TH AVE, POCATELLO, ID 83201-4015
(208) 650-9917
Mailing address
120 N 16TH AVE, POCATELLO, ID 83201-4015
(208) 650-9917
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
ID
Other
Enumeration date
01/13/2023
Last updated
01/13/2023
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