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1427410083
BRANDON SHORES
BOISE, ID
NPI
1427410083
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2016-03-23
Last Update Date
2016-03-23
Business Address
-- BRANDON SHORES MS
1720 N WESTGATE DR
BOISE, ID 83704-7164
Phone number: 208-334-0810
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Mailing Address
-- BRANDON SHORES MS
1720 N WESTGATE DR
BOISE, ID 83704-7164
Phone number: 208-334-0810
Copy
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