Individual
LILLIAN DETTMAN-RABLEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
875 PERIMETER DR, MOSCOW, ID 83844-9803
(985) 438-1647
Mailing address
901 W PARADISE CREEK ST, MOSCOW, ID 83843
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/04/2018
Last updated
07/14/2020
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