Individual
DR. JOHN EDWARD LANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2280 E 25TH ST, IDAHO FALLS, ID 83404-7542
(208) 227-2100
Mailing address
2280 E 25TH ST, IDAHO FALLS, ID 83404-7542
(208) 227-2100
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-202268
ID
Other
Enumeration date
06/07/2010
Last updated
06/07/2010
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