MIRANDA MICHELLE VAN DAM

MERIDIAN, ID
NPI1902565682
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy246ZC0007X Specialist/Technologist, Other, Surgical Assistant
(Licence: ID  205983)
Enumeration Date2021-12-10
Last Update Date2021-12-10
Business Address
MIRANDA MICHELLE VAN DAM CSFA
500 S. EAGLE RD.
MERIDIAN, ID 83642
Phone number: 208-706-8101
Mailing Address
MIRANDA MICHELLE VAN DAM CSFA
3595 W SPRUCE CREEK DR
MERIDIAN, ID 83642-4217
Phone number: 208-602-7289
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