Organization
VANNVEI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERESA GALL (CONTROLLER)
(509) 758-5511
Entity
Organization
Contact information
Practice address
1522 17TH ST, LEWISTON, ID 83501-3652
(208) 743-8416
Mailing address
PO BOX 341, LEWISTON, ID 83501-0341
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/18/2020
Last updated
11/30/2020
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