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1104454123
BRADEN LAWRENCE
NAMPA, ID
NPI
1104454123
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: ID M-16829)
Enumeration Date
2020-03-27
Last Update Date
2023-07-17
Business Address
BRADEN LAWRENCE MD
85 S MIDDLETON RD
NAMPA, ID 83651
Phone number: 208-381-4100
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Mailing Address
BRADEN LAWRENCE MD
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number:
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