MICHAEL HERNANDEZ

SHELLEY, ID
NPI1417666918
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date2022-11-23
Last Update Date2022-11-23
Business Address
MICHAEL HERNANDEZ
121 S BYRON AVE
SHELLEY, ID 83274-1209
Phone number: 208-881-3072
Mailing Address
MICHAEL HERNANDEZ
121 S BYRON AVE
SHELLEY, ID 83274-1209
Phone number: 208-881-3072