LOGAN FREDERICK PRINS

MOSCOW, ID
NPI1033770029
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: ID  AT-712)
Enumeration Date2019-06-21
Last Update Date2019-06-21
Business Address
LOGAN FREDERICK PRINS
875 PERIMETER DR
MOSCOW, ID 83844-9803
Phone number: 816-868-1839
Mailing Address
LOGAN FREDERICK PRINS
875 PERIMETER DR
MOSCOW, ID 83844-9803
Phone number:
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