BRYAN JAMES EARL

BOISE, ID
NPI1689476566
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: ID  8971859)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2025-03-24
Last Update Date2025-06-03
Business Address
BRYAN JAMES EARL DO
500 W FORT ST # 111R
BOISE, ID 83702-4501
Phone number: 208-422-1000
Mailing Address
BRYAN JAMES EARL DO
500 W FORT ST # 111R
BOISE, ID 83702-4501
Phone number: