Individual
TIMOTHY J SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1353
Mailing address
2594 E SALISBURY CT, EAGLE, ID 83616-6641
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P4727
ID
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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