Individual
MR. WAYNE KEITH AUSTIN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
700 12TH AVE S, NAMPA, ID 83651-4255
(208) 467-1560
Mailing address
700 12TH AVE S, NAMPA, ID 83651-4255
(208) 467-1560
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
3586
MT
183500000X
Pharmacist
P5472
ID
Other
Enumeration date
10/12/2011
Last updated
10/12/2011
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