Individual
SHELDON SKYLER BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT, CSMS-1
Contact information
Practice address
6165 W EMERALD ST, BOISE, ID 83704-8613
(208) 302-3500
Mailing address
6325 S ROCKROSE WAY, BOISE, ID 83716-7133
(208) 761-5396
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-696
ID
Other
Enumeration date
08/26/2019
Last updated
08/26/2019
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