Brandon Lane, PA

NPI #1689606667 in Caldwell, Idaho

Provider Information

NPI Number: 1689606667
Entity Type: Individual
Name: Brandon Lane, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Emergency Medicine
Credential: PA
Enumeration Date: Jul 7, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1717 ARLINGTON AVE
City: Caldwell
State: Idaho
ZIP Code: 83605-4802
Phone: (208) 459-4641

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Emergency Medicine	207P00000X	Primary

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