Individual
KIMBERLY HEINTZMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
8100 W FAIRVIEW AVE, BOISE, ID 83704-8425
(208) 375-2825
Mailing address
6890 W DANBURY LN, BOISE, ID 83709-5580
(208) 562-0352
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P4592
ID
Other
Enumeration date
10/27/2011
Last updated
10/27/2011
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