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1568153096
CARLY LANGE
BOISE, ID
NPI
1568153096
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163WG0000X Registered Nurse, General Practice
(Licence: ID 57823)
Enumeration Date
2023-05-16
Last Update Date
2023-05-16
Business Address
CARLY LANGE
417 S 6TH ST
BOISE, ID 83702-7632
Phone number: 208-577-4460
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Mailing Address
CARLY LANGE
417 S 6TH ST
BOISE, ID 83702-7632
Phone number:
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