Individual
BRANDON HANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1906 FAIRVIEW AVE STE 350, CALDWELL, ID 83605-5425
(208) 505-2101
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O-1730
ID
Other
Enumeration date
06/15/2017
Last updated
08/31/2022
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