Individual
MAKENNA LEE TURK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MAT, LAT, ATC
Contact information
Practice address
5530 N 4TH ST, COEUR D ALENE, ID 83815-9266
(406) 239-3543
Mailing address
4132 E 16TH AVE # D318, POST FALLS, ID 83854-2200
(406) 239-3543
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-717
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
N/A
—
Enumeration date
07/07/2017
Last updated
11/17/2020
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