NPI 1508472309

Bruce Kahl, ATHLETICTRAINER

Practitioner Sports Medicine (Preventive Medicine) Physician Eagle, ID

Practice location

Address: 574 N Park Ln, Eagle, ID 83616-4512
Phone: (208) 350-4235
Mailing address: 847 N Union Way, Star, ID 83669-6028

Registered specialties

Sports Medicine (Preventive Medicine) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2083S0010X Licence AT-698 (ID)

Other Preventive Medicine providers in Idaho →

Registry record

NPI: 1508472309
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Sep 2020
Record last updated: 17 Sep 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.