Individual
BROOKE HUEFTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(406) 490-9742
Mailing address
1659 S RIVERSTONE LN APT 102, BOISE, ID 83706-4062
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
10806103-1701
UT
183500000X
Pharmacist
Primary
P8328
ID
Other
Enumeration date
03/27/2020
Last updated
03/27/2020
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