JACKIE HENRY

RATHDRUM, ID
NPI1639136351
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: ID  AT-258)
Enumeration Date2006-04-27
Last Update Date2007-07-08
Business Address
-- JACKIE HENRY
6749 W EDEN CT
RATHDRUM, ID 83858-6423
Phone number: 208-687-2156
Mailing Address
-- JACKIE HENRY
6749 W EDEN CT
RATHDRUM, ID 83858-6423
Phone number: 208-687-2156