BRANDON LYNN MINER

IDAHO FALLS, ID
NPI1528279189
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207ND0101X Dermatology, MOHS-Micrographic Surgery
(Licence: ID  O-0568)
Enumeration Date2007-05-25
Last Update Date2013-10-17
Business Address
-- BRANDON LYNN MINER D.O
2085 PROVIDENCE WAY
IDAHO FALLS, ID 83404-4945
Phone number: 208-525-4888
Mailing Address
-- BRANDON LYNN MINER D.O
2085 PROVIDENCE WAY
IDAHO FALLS, ID 83404-4945
Phone number: 208-525-4888
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