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Individual

DAVID GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
725 POLE LINE RD W, TWIN FALLS, ID 83301-5860
(208) 814-1655
(208) 814-1917
Mailing address
725 POLE LINE RD W, TWIN FALLS, ID 83301-5860
(208) 814-1655
(208) 814-1917

Taxonomy

Speciality
Code
Description
License number
State
1835X0200X
Oncology Pharmacist
011601
KY
1835X0200X
Oncology Pharmacist
Primary
P5558
ID

Other

Enumeration date
12/16/2019
Last updated
12/16/2019
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