Individual
DR. JENNIFER DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 899-2123
Mailing address
4517 N RHODES AVE, MERIDIAN, ID 83646-6376
(208) 899-2123
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P8034
ID
Other
Enumeration date
11/05/2018
Last updated
11/05/2018
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