Individual
ALEXA HABERLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
346 RODEO DR, MOSCOW, ID 83843-9778
(425) 422-8302
Mailing address
15557 168TH AVE SE, MONROE, WA 98272-2887
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AT-592
ID
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/30/2017
Last updated
09/30/2017
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