-- BRANDON LANE -- PA
Individual Provider (NPI-1)
Active
Emergency Medicine
Provider Information
- NPI Number
1689606667- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PA
- Status
- Active
Contact & Location
- Address
- 1717 ARLINGTON AVE, CALDWELL, ID, 836054802
- Phone
- (208) 459-4641
Specialties & Taxonomies
Emergency Medicine
Primary License: ID #PA-413
All Addresses
MAILING
818 MCKINLEY ST
BOISE, ID, 837126416