BRANDON LANE

CALDWELL, ID
NPI1689606667
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: ID  PA-413)
Enumeration Date2006-07-07
Last Update Date2007-07-08
Business Address
-- BRANDON LANE PA
1717 ARLINGTON AVE
CALDWELL, ID 83605-4802
Phone number: 208-459-4641
Mailing Address
-- BRANDON LANE PA
818 MCKINLEY ST
BOISE, ID 83712-6416
Phone number:
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