Individual
OPAL GRIFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
190 E. BANNOCK STREET, BOISE, ID 83712-9987
(208) 381-2222
Mailing address
7916 W RYGATE CT, BOISE, ID 83714-6806
(208) 850-2799
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-315
ID
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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