Individual
JORDAN LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
520 S EAGLE RD, MERIDIAN, ID 83642
(208) 706-5000
(208) 706-5000
Mailing address
4459 N ELSINORE AVE, MERIDIAN, ID 83646-6259
(208) 954-4558
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P8374
ID
Other
Enumeration date
01/07/2020
Last updated
01/07/2020
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