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Individual

ANDREW JAY HAMMERQUIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4884 S WHITMORE WAY, BOISE, ID 83709-3465
(208) 810-3832
Mailing address
4884 S WHITMORE WAY, BOISE, ID 83709-3465
(208) 810-3832

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-579
ID

Other

Enumeration date
11/09/2018
Last updated
11/09/2018
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