Individual
HANNAH ALFARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
875 PERIMETER DR # MS 2401, MOSCOW, ID 83844-9803
(208) 885-1673
Mailing address
226 N LIEUALLEN ST, MOSCOW, ID 83843-2141
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XDP009A55228
ANTHEM
CA
Enumeration date
06/01/2022
Last updated
06/01/2022
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