KENNETH VERLAGE

BOISE, ID
NPI1730620907
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208800000X Urology
(Licence: ID  M-17493)
Additional Taxonomies208800000X Urology
(Licence: OR  MD210158)
Enumeration Date2017-03-20
Last Update Date2023-10-10
Business Address
KENNETH VERLAGE
510 N 2ND ST STE 102
BOISE, ID 83702-6077
Phone number: 208-381-4700
Mailing Address
KENNETH VERLAGE
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: