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1346765047
ALEXANDRA LONG
BOISE, ID
NPI
1346765047
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: ID 2000020432)
Enumeration Date
2017-08-03
Last Update Date
2017-08-03
Business Address
ALEXANDRA LONG ATC
1010 W WASHINGTON ST
BOISE, ID 83702-5446
Phone number: 208-854-4270
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Mailing Address
ALEXANDRA LONG ATC
628 WINTER PL
NAMPA, ID 83686-2988
Phone number:
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