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Individual

CLARISSA ALEXANDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
331 LA VALLE STRADA, POCATELLO, ID 83201-5822
(208) 921-1916
Mailing address
331 LA VALLE STRADA, POCATELLO, ID 83201-5822
(208) 921-1916

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
551
ID

Other

Enumeration date
11/21/2017
Last updated
11/21/2017
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