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1417518408
KASSANDRA JOHNSON
MOSCOW, ID
NPI
1417518408
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: ID AT-649)
Enumeration Date
2019-06-21
Last Update Date
2019-06-21
Business Address
KASSANDRA JOHNSON
875 PERIMETER DR
MOSCOW, ID 83844-9803
Phone number: 208-885-6111
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Mailing Address
KASSANDRA JOHNSON
875 PERIMETER DR
MOSCOW, ID 83844-9803
Phone number:
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