Individual
STEPHANE COLLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1121 W A ST APT 8, MOSCOW, ID 83843-4610
(208) 310-2412
Mailing address
276 RUE DOLBEC, ST-EUSTACHE, QUBEC J7R6N-5
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/17/2019
Last updated
07/21/2022
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