DANE VANDER WALL

BOISE, ID
NPI1053190348
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy261QM2500X Clinic/Center, Medical Specialty
Enumeration Date2023-09-26
Last Update Date2023-09-26
Business Address
DANE VANDER WALL ND
9757 W ARNOLD RD
BOISE, ID 83714-8210
Phone number: 720-220-5331
Mailing Address
DANE VANDER WALL ND
9757 W ARNOLD RD
BOISE, ID 83714-8210
Phone number: 720-220-5331
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