Individual
ALAN BLAKE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC.
Contact information
Practice address
1412 COLUMBUS ST, BOISE, ID 83705-2507
(208) 284-0313
Mailing address
1412 COLUMBUS ST, BOISE, ID 83705-2507
(208) 284-0313
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
ACU-212
ID
Other
Enumeration date
09/13/2010
Last updated
09/13/2010
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