Individual
DAN LOREN WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
256 N 2ND E, REXBURG, ID 83440-1638
(208) 656-9646
(208) 656-9646
Mailing address
256 N 2ND E, REXBURG, ID 83440-1638
(208) 656-9646
(208) 656-9646
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-213
ID
Other
Enumeration date
06/23/2006
Last updated
06/11/2014
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