Individual
MR. EDWARD M BOSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
6505 N ILLINOIS ST, FAIRVIEW HEIGHTS, IL 62208-2001
(618) 394-8744
Mailing address
6505 N ILLINOIS ST, FAIRVIEW HEIGHTS, IL 62208-2001
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.032056
IL
Other
Enumeration date
10/11/2011
Last updated
10/11/2011
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