Individual
MR. RANDY EUGENE BOSWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, ATC, LAT
Contact information
Practice address
1000 W GARDEN AVE, COEUR D ALENE, ID 83814-2161
(208) 769-3217
(208) 769-7779
Mailing address
1000 W GARDEN AVE, COEUR D ALENE, ID 83814-2161
(208) 769-3217
(208) 769-7779
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/19/2009
Last updated
06/19/2009
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