Individual
ARTOUN GOSTANTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4110 S 10TH AVE, CALDWELL, ID 83605-5706
(208) 402-0154
Mailing address
10006 W SMOKE RANCH DR, BOISE, ID 83709-1200
(916) 513-9026
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P9624
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
IDTPID018322
—
ID
Enumeration date
10/22/2021
Last updated
10/25/2021
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