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1720655111
HUNTER ISAAC JOHNSON
MOSCOW, ID
NPI
1720655111
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2021-06-05
Last Update Date
2021-06-05
Business Address
HUNTER ISAAC JOHNSON
875 PERIMETER DR # MS 4250
MOSCOW, ID 83844-9803
Phone number: 208-885-6111
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Mailing Address
HUNTER ISAAC JOHNSON
804 ELM ST
MOSCOW, ID 83843-4142
Phone number: 208-277-8709
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