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Individual

CYRUS H VANIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
8971 W OVERLAND RD, BOISE, ID 83709-1651
(208) 378-4288
(208) 378-4297
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 955-6522
(208) 955-6503

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5101018756
MI
207Q00000X
Family Medicine Physician
Primary
O-0735
ID

Other

Enumeration date
07/18/2010
Last updated
08/01/2013
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