Individual
MR. ANTHONY DUANE FITZPATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
701 E BOISE AVE, BOISE, ID 83706-5119
(208) 854-6230
(208) 854-6232
Mailing address
3915 E WORMWOOD CT, BOISE, ID 83716-6938
(208) 331-5077
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT035
ID
Other
Enumeration date
06/30/2006
Last updated
07/08/2007
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