Individual
MISS JACQUELINE M WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
UNIVERSITY OF IDAHO, DEPT. OF HPERD PEB 100, MOSCOW, ID 83844-2401
(208) 885-2185
(208) 885-5929
Mailing address
927 VANDAL DR, MOSCOW, ID 83843-9229
(208) 882-7140
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-106
ID
Other
Enumeration date
08/12/2006
Last updated
07/08/2007
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