Individual
DAVID BLAIR WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(208) 381-7189
Mailing address
2040 S RIDGE POINT WAY, BOISE, ID 83712-8515
Taxonomy
Speciality
Code
Description
License number
State
1835X0200X
Oncology Pharmacist
Primary
P4166
ID
Other
Enumeration date
12/16/2019
Last updated
12/16/2019
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