Individual
NATHAN BURNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
136 N 100 W, PRESTON, ID 83263-1062
(208) 851-0777
Mailing address
136 N 100 W, PRESTON, ID 83263-1062
(208) 851-0777
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-245
ID
Other
Enumeration date
04/08/2016
Last updated
04/08/2016
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