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Contact Information

LISA M ROPER, B.S, ATC, LAT
1900 W PINE AVE
MERIDIAN, ID83642-1961
 Phone: 208-350-4160
 Fax: 208-350-4178
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist/Technologist

225500000X
 

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for LISA M ROPER · (Female)

NPI Number 1063455608
Status Active
Credentials B.S, ATC, LAT
Entity Individual
Enumeration date 06/13/2006
Last updated 12/03/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • ID License # AT-374
  • OR License # AT-AT-148663
  • OR Other 1063455608 AT-374
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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