Individual
ERICA RUNYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
709 S DEAKIN ST, MOSCOW, ID 83844-9802
(360) 621-1243
Mailing address
300 SW KIMBALL DR APT A, PULLMAN, WA 99163-2112
(360) 621-1243
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/01/2017
Last updated
06/01/2017
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