Individual
CAMARYN BRICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
520 S EAGLE RD STE 3213, MERIDIAN, ID 83642-6356
(208) 706-5000
Mailing address
180 EDYTHE ST, LIVERMORE, CA 94550-4019
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-840
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000051191
NATA BOARD OF CERTIFICATION
ID
01
—
AT-840
IDAHO BOARD OF MEDICINE
ID
Enumeration date
10/14/2022
Last updated
10/14/2022
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