SAMANTHA PATRICIA BOURASSA

POST FALLS, ID
NPI1245792910
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: ID  AT-436)
Enumeration Date2019-04-02
Last Update Date2019-04-02
Business Address
Mrs. SAMANTHA PATRICIA BOURASSA ATC, LAT
2832 E POLELINE AVE
POST FALLS, ID 83854
Phone number: 208-773-0581
Mailing Address
Mrs. SAMANTHA PATRICIA BOURASSA ATC, LAT
1852 DIPPER LOOP
POST FALLS, ID 83854-5647
Phone number: 406-899-3757
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