Individual
BRANDON LYNN MINER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
2085 PROVIDENCE WAY, IDAHO FALLS, ID 83404-4945
(208) 525-4888
(208) 525-4885
Mailing address
2085 PROVIDENCE WAY, IDAHO FALLS, ID 83404-4945
(208) 525-4888
(208) 525-4885
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
O-0568
ID
Other
Enumeration date
05/25/2007
Last updated
10/17/2013
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