Individual
JIANCHENG WU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1219 S BROADWAY AVE, BOISE, ID 83706-3701
(208) 433-9905
Mailing address
1219 BROADWAY AVENUE, BOISE, ID 83706
(208) 433-9905
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P7275
ID
Other
Enumeration date
06/12/2015
Last updated
06/12/2015
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