SHANE A MAXWELL

MERIDIAN, ID
NPI1508825456
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208VP0014X Pain Medicine, Interventional Pain Medicine
(Licence: ID  O0385)
Enumeration Date2006-03-20
Last Update Date2022-07-21
Business Address
Mr. SHANE A MAXWELL D.O.
3551 E OVERLAND RD
MERIDIAN, ID 83642-6757
Phone number: 208-884-1333
Mailing Address
Mr. SHANE A MAXWELL D.O.
PO BOX 1128
BOISE, ID 83701-1128
Phone number: 208-381-2222
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