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1003980210
VICTORIA ELEANOR RYAN
POCATELLO, ID
NPI
1003980210
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: ID PA-626)
Enumeration Date
2006-11-20
Last Update Date
2015-09-10
Business Address
Ms. VICTORIA ELEANOR RYAN PA-C
990 CESAR CHAVEZ AVE
POCATELLO, ID 83209-0001
Phone number: 208-282-2330
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Mailing Address
Ms. VICTORIA ELEANOR RYAN PA-C
990 CESAR CHAVEZ AVE
POCATELLO, ID 83209-0001
Phone number:
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