MARY-GRACE TESTA

BOISE, ID
NPI1952073934
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist Athletic Trainer
(Licence: ID  AT-793)
Additional Taxonomies2255A2300X Specialist/Technologist Athletic Trainer
(Licence: NJ  25MT00264200)
Enumeration Date2021-09-29
Last Update Date2021-09-29
Business Address
MARY-GRACE TESTA ATC
1401 BRONCO LANE
BOISE, ID 83706
Phone number: 208-579-0284
Mailing Address
MARY-GRACE TESTA ATC
1249 W GRAND AVE APT 401
BOISE, ID 83702-6999
Phone number: 201-290-4460