Individual
LETICIA JUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5005 W OVERLAND RD, BOISE, ID 83705-2633
(208) 389-1448
Mailing address
9372 W HALSTEAD DR, BOISE, ID 83704-6414
(208) 490-2337
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P8066
ID
Other
Enumeration date
07/14/2018
Last updated
07/14/2018
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