Individual
MR. BRANDON CHARLES PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
921 S 8TH AVE STOP 8173, POCATELLO, ID 83209-0002
(989) 621-2374
Mailing address
921 S 8TH AVE STOP 8173, POCATELLO, ID 83209-0002
(989) 621-2374
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/19/2017
Last updated
07/21/2022
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