Individual
DR. TY CURTIS BAZIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1545 E 6TH ST, WEISER, ID 83672-1495
(208) 549-8777
(208) 549-8780
Mailing address
1545 E 6TH ST, WEISER, ID 83672-1495
(208) 549-8777
(208) 549-8780
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6159
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P6159
STATE PHARMACIST LICENSE
ID
Enumeration date
02/10/2012
Last updated
02/10/2012
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