Individual
AVERY BRIANNE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
36 5TH ST N, NAMPA, ID 83687-3482
(605) 880-8886
Mailing address
36 5TH ST N, NAMPA, ID 83687-3482
(605) 880-8886
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-531
ID
Other
Enumeration date
01/26/2015
Last updated
01/26/2015
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