Individual
ANSLEY KATHRYN SMALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
1910 UNIVERSITY DR, BOISE, ID 83725-0001
(210) 416-1998
Mailing address
4212 S FEDERAL WAY APT U102, BOISE, ID 83716-5587
(210) 416-1998
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
AT-473
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT-473
IDAHO BOARD OF MEDICINE
ID
Enumeration date
08/07/2014
Last updated
08/07/2014
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