Individual
MR. NEIL WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
215 E HAWAII AVE, NAMPA, ID 83686-6011
(208) 466-7823
(208) 466-8429
Mailing address
3502 W ELM CREEK DR, MERIDIAN, ID 83642-4231
(208) 884-1317
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5405
ID
Other
Enumeration date
01/20/2014
Last updated
01/20/2014
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