Individual
KELSIE GARTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, AT
Contact information
Practice address
640 W HAZEL ST, GENESEE, ID 83832-9547
(208) 310-6004
Mailing address
PO BOX 103, GENESEE, ID 83832-0103
(208) 310-6004
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/06/2014
Last updated
07/06/2014
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