Individual
RICHARD GILLESPIE V
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT, RCEP
Contact information
Practice address
251 S CAPITOL BLVD, BOISE, ID 83702-7220
(208) 472-2200
Mailing address
251 S CAPITOL BLVD, BOISE, ID 83702-7220
Taxonomy
Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
637759
FL
2255A2300X
Athletic Trainer
Primary
AT-490
ID
Other
Enumeration date
07/30/2014
Last updated
07/30/2014
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