Individual
KAILEY WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
520 S EAGLE RD, MERIDIAN, ID 83642-6351
(208) 706-5000
Mailing address
5245 W MORRIS HILL RD, BOISE, ID 83706-1616
(805) 610-9751
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-782
ID
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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