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1891416889
SAMANTHA WADE
BOISE, ID
NPI
1891416889
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Former Name
SAMANTHA SHANAHAN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: ID D-1287)
Enumeration Date
2022-09-07
Last Update Date
2022-09-07
Business Address
SAMANTHA WADE RD
1910 UNIVERSITY DR
BOISE, ID 83725-0002
Phone number: 206-795-2335
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Mailing Address
SAMANTHA WADE RD
1910 UNIVERSITY DR
BOISE, ID 83725-0002
Phone number:
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