Individual
AMBER VANIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4971 W. OVERLAND ROAD, BOISE, ID 83705
(208) 472-5050
(208) 472-5051
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 955-6500
(208) 955-6503
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O0755
ID
Other
Enumeration date
07/18/2010
Last updated
10/08/2015
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