Individual
HAILIE COWDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
550 MEMORIAL DR, POCATELLO, ID 83201-4063
(208) 282-3408
Mailing address
1038 DEON DR., POCATELLO, ID 83201
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2018
Last updated
10/15/2019
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