Individual
MCKENZI ADAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC, LAT, CSCS
Contact information
Practice address
1300 W PARK ST, BUTTE, MT 59701-8932
(406) 496-4296
Mailing address
397 APPALOOSA AVE, POCATELLO, ID 83201-7009
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATC-LAT-LIC-1901
MT
2255A2300X
Athletic Trainer
—
ID
Other
Enumeration date
03/26/2018
Last updated
12/30/2019
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