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Individual

ISIS BARRAGAN GOMEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC, LAT

Contact information

Practice address
875 PERIMETER DR # MS -2302, MOSCOW, ID 83844-2476
(720) 285-6375
(208) 885-0254
Mailing address
1915 NE TERRE VIEW DR APT 68D, PULLMAN, WA 99163-5718

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
7961767
ID

Other

Enumeration date
07/28/2022
Last updated
09/23/2024
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