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1346792033
SAMANTHA RAE LANGE
BOISE, ID
NPI
1346792033
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-1432)
Enumeration Date
2016-10-27
Last Update Date
2019-06-10
Business Address
SAMANTHA RAE LANGE PA-C
1072 N LIBERTY ST STE 203
BOISE, ID 83704
Phone number: 208-302-5800
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Mailing Address
SAMANTHA RAE LANGE PA-C
2115 ENELL ST
IDAHO FALLS, ID 83402-2911
Phone number: 208-302-5800
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