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Carly Wilson, MS, LAT, ATC — NPI 1205326642, Boise, ID | NPI Central

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NPI 1205326642

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Carly Wilson, MS, LAT, ATC

NPI 1205326642 · Athletic Trainer · Boise, ID

Provider details

NPI number: 1205326642
Entity type: Individual
Primary specialty: Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Credential: MS, LAT, ATC
Sex: Female
Sole proprietor: No

Specialties & taxonomies

Athletic TrainerPrimary2255A2300X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Student in an Organized Health Care Education/Training Program390200000X
Student, Health Care

Practice location

1109 W Myrtle St Ste 200

Boise, ID 83702-6975

Phone: (208) 489-4300

Approximate (ZIP-level) locationGet directions

More ID providers

Mailing address

1051 Southern Dr Unit 2108

Columbia, SC 29201-5608

Additional practice locations (2)

Blatt Pe Center - Exercise Science 1300 Wheat Street
Columbia, SC 29208-1121
Phone: (803) 777-0636
2000 Observatory Dr
Madison, WI 53706-1121
Phone: (608) 262-3742

Registry dates

Enumerated: 2018-05-10
Last updated: 2021-09-09
Certified: 2021-09-09

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.