Individual
SHANNON KATHLEEN LANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
600 N ROBBINS RD STE 302, BOISE, ID 83702-4565
(208) 706-5930
(208) 706-5942
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 706-5942
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
O-1817
ID
Other
Enumeration date
04/02/2018
Last updated
08/23/2023
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