Most Relevant Information
Provider Data
| NPI Number: | 1003662123 |
| Provider Name: | BRYAN DAVID LITTLE MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/29/2024 |
| Last Updated: | 04/29/2024 |
Provider Practice Location
500 W FORT ST BLDG 116
BOISE
ID
837024501
Practice Location Phone/Fax
| Phone: | 2084221165 |
| Fax: |
Provider Mailing Location
500 W FORT ST BLDG 116
BOISE
ID
837024501
Provider Mailing Phone/Fax
| Phone: | 2084221165 |
| Fax: |