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Individual

LEXIS FOUTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
617 W TAYLOR AVE # A, MOSCOW, ID 83843-2411
(208) 964-5936
Mailing address
617 W TAYLOR AVE # A, MOSCOW, ID 83843-2411
(208) 964-5936

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
07/13/2020
Last updated
07/13/2020
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