Individual
MCKENLEY BOAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1227 RIVERSIDE AVE APT 60, PROVO, UT 84604-3288
(713) 330-9308
Mailing address
1227 RIVERSIDE AVE APT 60, PROVO, UT 84604-3288
(713) 330-9308
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
425914
UT
Other
Enumeration date
04/22/2025
Last updated
04/22/2025
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