Individual
JEAN ANNE VANDENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
91 E CROY ST, HAILEY, ID 83333-8877
(208) 788-9714
Mailing address
PO BOX 2468, HAILEY, ID 83333-2468
(208) 788-1167
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5008
ID
Other
Enumeration date
08/20/2007
Last updated
07/05/2025
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