TARA ANNE KISHPAUGH

EAGLE, ID
NPI1588704118
Former NameTARA ANNE PRICE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: ID  AT-280)
Enumeration Date2007-02-06
Last Update Date2007-07-08
Business Address
Mrs. TARA ANNE KISHPAUGH LAT, AT.,C
574 PARK LN
EAGLE, ID 83616-4512
Phone number: 208-939-2189
Mailing Address
Mrs. TARA ANNE KISHPAUGH LAT, AT.,C
1229 FLEETWOOD LN
BOISE, ID 83706-4541
Phone number: 208-866-9495
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