Individual
CHARLES HOLMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1323 S MAPLE GROVE RD, BOISE, ID 83709-1610
(208) 319-0967
Mailing address
1323 S MAPLE GROVE RD, BOISE, ID 83709-1610
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P7175
ID
Other
Enumeration date
12/01/2014
Last updated
12/01/2014
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