Individual
JIM V NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2490
Mailing address
3882 W TETER ST, MERIDIAN, ID 83642-3976
(208) 409-0910
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
P5658
ID
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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