Individual
TRACY ANN COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
621 19TH AVE, LEWISTON, ID 83501-3893
(208) 791-8582
(208) 792-2183
Mailing address
621 19TH AVE, LEWISTON, ID 83501-3893
(208) 791-8582
(208) 792-2183
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-143
ID
Other
Enumeration date
03/30/2012
Last updated
03/30/2012
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