Individual
MS. VICTORIA ELEANOR RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
990 CESAR CHAVEZ AVE, POCATELLO, ID 83209-0001
(208) 282-2330
Mailing address
990 CESAR CHAVEZ AVE, POCATELLO, ID 83209-0001
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PA-626
ID
Other
Enumeration date
11/20/2006
Last updated
09/10/2015
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