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Individual

BROOKLYN MCNEIL GRANGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
8921 W HACKAMORE DR, BOISE, ID 83709-1673
(208) 994-4123
(800) 431-6309
Mailing address
8921 W HACKAMORE DR, BOISE, ID 83709-1673
(208) 994-4123
(800) 431-6309

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1427730738
ID

Other

Enumeration date
08/04/2023
Last updated
11/24/2025
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