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1750330080
SHANDA GROOMS
MERIDIAN, ID
NPI
1750330080
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: ID M8196)
Enumeration Date
2006-05-05
Last Update Date
2011-02-23
Business Address
SHANDA GROOMS M.D.
520 S EAGLE RD STE 3102
MERIDIAN, ID 83642-6351
Phone number: 208-706-5100
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Mailing Address
SHANDA GROOMS M.D.
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-2222
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