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1487319612
TREY BRAEDON LANE
NAMPA, ID
NPI
1487319612
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: ID PT-7506)
Enumeration Date
2021-11-02
Last Update Date
2021-11-02
Business Address
Dr. TREY BRAEDON LANE DPT
130 S MIDLAND BLVD
NAMPA, ID 83686-2601
Phone number: 208-461-5057
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Mailing Address
Dr. TREY BRAEDON LANE DPT
130 S MIDLAND BLVD
NAMPA, ID 83686-2601
Phone number: 208-461-5057
Copy
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