BRANDON MICAH BREVIG

BOISE, ID
NPI1306057641
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy208100000X Physical Medicine & Rehabilitation
(Licence: NY  11-6037195)
Enumeration Date2007-05-25
Last Update Date2016-01-06
Business Address
Dr. BRANDON MICAH BREVIG D.O.
302 W IDAHO ST
BOISE, ID 83702-6039
Phone number: 208-994-4962
Mailing Address
Dr. BRANDON MICAH BREVIG D.O.
2032 E SIDEWINDER DR
MERIDIAN, ID 83646-5867
Phone number: 208-488-8408