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Individual

JORDAHN SAIGE WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
875 PERIMETER DR # MS 2401, MOSCOW, ID 83844-9803
(208) 794-7145
Mailing address
1673 S LEVICK ST APT 3, MOSCOW, ID 83843-4447
(208) 794-7145

Taxonomy

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

Other

Enumeration date
06/01/2018
Last updated
06/01/2018
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