Individual
PHILLIP KYLE ROYLANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-6416
(208) 367-2742
Mailing address
PO BOX 4008, PORTLAND, OR 97208-4008
(503) 372-2740
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA763
ID
Other
Enumeration date
09/29/2009
Last updated
10/09/2009
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