TRAVIS JOHN POULSON

BOISE, ID
NPI1609453380
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2081S0010X Physical Medicine & Rehabilitation Sports Medicine
(Licence: ID  AT-713)
Enumeration Date2021-03-27
Last Update Date2021-03-27
Business Address
TRAVIS JOHN POULSON LAT, ATC, CSCS
1910 UNIVERSITY DR
BOISE, ID 83725-0002
Phone number: 262-949-4026
Mailing Address
TRAVIS JOHN POULSON LAT, ATC, CSCS
N300 TOWER RD
EAGLE, WI 53119-1914
Phone number: 262-949-4026
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