Individual
MARCELA WIETSTRUCK HEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(720) 800-2851
Mailing address
100 E IDAHO ST, BOISE, ID 83712-6267
(720) 800-2851
Taxonomy
Speciality
Code
Description
License number
State
1835X0200X
Oncology Pharmacist
Primary
P10126
ID
Other
Enumeration date
07/12/2023
Last updated
10/29/2024
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