Individual
ALISHA ELLEDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NASM CPT
Contact information
Practice address
110 NW WILCOX DR, MOUNTAIN HOME, ID 83647-5831
(208) 599-2354
Mailing address
110 NW WILCOX DR, MOUNTAIN HOME, ID 83647-5831
(208) 599-2354
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
171400000X
Health & Wellness Coach
Primary
—
—
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
04/28/2025
Last updated
04/28/2025
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