Kassandra Johnson Valid NPI

Individual provider · Athletic Trainer · Moscow, ID

NPI

1417518408

Type

Individual (Type 1)

Primary specialty

Athletic Trainer (Specialist/Technologist)

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

2255A2300X

License number

AT-649 (ID)

Sex

Female

Sole proprietor

No

Enumerated

2019-06-21

Last updated

2019-06-21