Individual
MAIA ISABEL GAJATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1910 UNIVERSITY DR, BOISE, ID 83725-0001
(208) 426-1000
Mailing address
6875 W PREECE LN, BOISE, ID 83704-8677
(986) 837-6529
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/16/2022
Last updated
02/18/2022
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