Individual
SANTIAGO A SEGURA BARRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED, LAT, ATC
Contact information
Practice address
HOLT ARENA 550 MEMORIAL DRIVE BUILDING 50, POCATELLO, ID 83209-0001
(208) 282-3408
Mailing address
641 W BONNEVILLE ST, POCATELLO, ID 83204-3338
(641) 295-2760
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-751
ID
Other
Enumeration date
06/23/2020
Last updated
06/23/2020
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