IndividualActive
Dane Vander Wall, ND
NPI 1053190348 · Medical Specialty Clinic/Center · Boise, ID
Provider details
- NPI number
- 1053190348
- Entity type
- Individual
- Primary specialty
- Medical Specialty Clinic/CenterAmbulatory Health Care Facilities
- Credential
- ND
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
9757 W Arnold Rd
Boise, ID 83714-8210
Phone: (720) 220-5331
Approximate (ZIP-level) locationGet directions
Mailing address
9757 W Arnold Rd
Boise, ID 83714-8210
Registry dates
- Enumerated
- 2023-09-26
- Last updated
- 2023-09-26
- Certified
- 2023-09-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.