Individual
MR. RYAN R VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD, LD
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
500 W FORT ST, BOISE, ID 83702-4501
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
943479
ID
Other
Enumeration date
07/23/2008
Last updated
03/02/2010
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