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Lucas Bahnmaier, MS, ATC/L, OTC

Specialist/Technologist, Athletic Trainer in Boise, ID. Individual provider (NPI-1).

NPI number1982940011
StatusActive
Last updated in NPPESDec 18, 2012

Details

NPI
1982940011
Entity type
Individual (NPI-1)
Name
Lucas Bahnmaier
Credential
MS, ATC/L, OTC
Sex
Male
Sole proprietor
No
Enumeration date
Dec 18, 2012
Last updated
Dec 18, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic TrainerAT-425IDYes

Practice location

1109 W Myrtle St
Suite 200
Boise, ID 83702-6970

Phone 208-489-4299 · Fax 208-489-4300

Mailing address

1109 W Myrtle St
Suite 200
Boise, ID 83702-6970

Phone 208-489-4299 · Fax 208-489-4300

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