Individual
NATHAN ALAN BANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.T
Contact information
Practice address
1800 N SUMMER ROSE ST, POST FALLS, ID 83854-6003
(208) 277-5338
Mailing address
1800 N SUMMER ROSE ST, POST FALLS, ID 83854-6003
(208) 277-5338
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
529099
ID
Other
Enumeration date
10/23/2014
Last updated
10/23/2014
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