Individual
GAYLA TANAKA BOLLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
(208) 422-1198
Mailing address
202 N STRAUGHAN AVE, BOISE, ID 83712-6403
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5519
ID
Other
Enumeration date
12/04/2006
Last updated
07/08/2007
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