Individual
MR. BRUCE KAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATHLETIC TRAINER
Contact information
Practice address
574 N PARK LN, EAGLE, ID 83616-4512
(208) 350-4235
Mailing address
847 N UNION WAY, STAR, ID 83669-6028
(775) 354-7900
Taxonomy
Speciality
Code
Description
License number
State
2083S0010X
Sports Medicine (Preventive Medicine) Physician
Primary
AT-698
ID
Other
Enumeration date
09/17/2020
Last updated
09/17/2020
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