Individual
ALEXANDRA ALENE FARLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1416 N RAYMOND ST APT 101, BOISE, ID 83704-0694
(509) 994-9699
Mailing address
1416 N RAYMOND ST APT 101, BOISE, ID 83704-0694
(509) 994-9699
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
ID
Other
Enumeration date
03/30/2012
Last updated
03/30/2012
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