Individual
RANAE DAVISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDMS
Contact information
Practice address
1515 NEWPORT ST, BOISE, ID 83709-3008
(208) 539-9924
Mailing address
1515 NEWPORT ST, BOISE, ID 83709-3008
(208) 539-9924
Taxonomy
Speciality
Code
Description
License number
State
2471S1302X
Sonography Radiologic Technologist
Primary
92611
ID
Other
Enumeration date
09/30/2011
Last updated
09/30/2011
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