DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DANE VANDER WALL, ND

Active Sole Proprietor

DANE VANDER WALL, ND is a Medical Specialty Clinic healthcare provider located in BOISE, Idaho. NPI 1053190348 is currently active in the NPPES registry. Verify at CMS.

Medical Specialty Clinic · BOISE, ID

Registration Details

NPI Number
1053190348
Provider Type
Individual
Gender
Male
NPI Issued
Sep 26, 2023 (2.8418730006775 yrs)
Last Updated
Sep 26, 2023
Sole Proprietor
Yes

Practice Information

Address
9757 W ARNOLD RD
BOISE, ID, 837148210
Browse ID providers · Browse ZIP 83714
Phone
7202205331
Primary Specialty
Medical Specialty Clinic
261QM2500X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.