Individual
BRADLEY MEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
801 POLE LINE RD W, TWIN FALLS, ID 83301-5810
(208) 814-8500
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
M-16705
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2019
Last updated
07/27/2023
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