Individual provider · Type 1 NPI
Dane Vander Wall, ND
Medical Specialty Clinic/Center · Boise, ID
NPI number
1053190348
Active
Practice location
9757 W Arnold Rd
Boise, ID 83714-8210
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Specialty Clinic/Center Primary | 261QM2500X | None listed |
Medical Specialty Clinic/Center: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
About NPI 1053190348
Dane Vander Wall, ND's National Provider Identifier is 1053190348, issued on Sep 26, 2023. The primary taxonomy on file is Medical Specialty Clinic/Center (261QM2500X), and the practice location is in Boise, ID. The record was last updated on Sep 26, 2023.