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Individual

MORGAN BREEANNA BENGTZEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC, LAT, MAL

Contact information

Practice address
701 E BOISE AVE, BOISE, ID 83706-5119
(801) 702-7713
Mailing address
2624 W LUSTERPOINTE LN, WEST JORDAN, UT 84088-5281
(801) 702-7713

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
01/29/2020
Last updated
01/08/2024
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