BRELAN J LANE

POCATELLO, ID
NPI1336572858
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: ID  PT-3257)
Enumeration Date2013-08-20
Last Update Date2013-08-20
Business Address
-- BRELAN J LANE DPT
495 YELLOWSTONE AVE SUITE A
POCATELLO, ID 83201-4531
Phone number: 208-232-9198
Mailing Address
-- BRELAN J LANE DPT
1560 S CAROL ST
MERIDIAN, ID 83646-1839
Phone number: 208-288-1155
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