Individual
MISS LORA ELISABETH THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.T.C.
Contact information
Practice address
301 S. HAPPY VALLEY ROAD, NAMPA, ID 83687
(208) 468-4601
Mailing address
2751 DUANE DR, MERIDIAN, ID 83642-5807
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-287
ID
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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