Individual
MS. CHEREE IADEVAIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
2375 E SUNNYSIDE RD, SUITE F, IDAHO FALLS, ID 83404-8280
(208) 535-3626
Mailing address
2375 E SUNNYSIDE RD, SUITE F, IDAHO FALLS, ID 83404-8280
(208) 535-3626
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-529
ID
Other
Enumeration date
05/30/2012
Last updated
01/20/2017
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