Individual
MR. DALLEN FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
306 BLUE LAKES BLVD N, TWIN FALLS, ID 83301-4827
(208) 734-4053
(208) 734-4295
Mailing address
659 CROCUS LN, PAUL, ID 83347-8600
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P4564
ID
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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