Individual
MR. SHANE DARNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
449 BERRETT AVE, SHELLEY, ID 83274-1201
(208) 529-6148
(208) 529-7061
Mailing address
449 BERRETT AVE, SHELLEY, ID 83274-1201
(208) 529-6148
(208) 529-7061
Taxonomy
Speciality
Code
Description
License number
State
246ZE0500X
EEG Specialist/Technologist
Primary
11
ID
Other
Enumeration date
12/10/2015
Last updated
12/10/2015
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