Individual
JASON HEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8093 N CORNERSTONE DR, HAYDEN, ID 83835-8753
(208) 762-9355
Mailing address
8093 N CORNERSTONE DR, HAYDEN, ID 83835-8753
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6437
ID
Other
Enumeration date
03/05/2014
Last updated
03/05/2014
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