Individual
JACOB ANDREW STUTZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
90 HOPE DR, MOUNTAIN HOME AFB, ID 83648-1057
(208) 828-7521
Mailing address
90 HOPE DR, MOUNTAIN HOME AFB, ID 83648-1057
(208) 828-7521
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
61056660
WA
183500000X
Pharmacist
Primary
P10003
ID
Other
Enumeration date
09/26/2020
Last updated
04/16/2024
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