Individual
ELLA MIKLAIN VANALFEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2411 N BISCAYNE PL, EAGLE, ID 83616-5442
(208) 991-6677
Mailing address
2411 N BISCAYNE PL, EAGLE, ID 83616-5442
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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