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1124542147
WILLIAM BRADFORD LANE
POCATELLO, ID
NPI
1124542147
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
(Licence: ID LPC-6550)
Enumeration Date
2017-08-01
Last Update Date
2022-07-21
Business Address
Mr. WILLIAM BRADFORD LANE LPC
409 WASHINGTON AVE
POCATELLO, ID 83201-4520
Phone number: 208-234-2646
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Mailing Address
Mr. WILLIAM BRADFORD LANE LPC
409 WASHINGTON AVE
POCATELLO, ID 83201-4520
Phone number: 208-234-2646
Copy
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