LUCAS ALEXANDER BRYAN

POCATELLO, ID
NPI1598289274
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist Athletic Trainer
Enumeration Date2017-08-03
Last Update Date2019-07-25
Business Address
LUCAS ALEXANDER BRYAN
1535 E TERRY ST
POCATELLO, ID 83201
Phone number: 208-881-4385
Mailing Address
LUCAS ALEXANDER BRYAN
PO BOX 545
IONA, ID 83427-0545
Phone number: 208-529-3096
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