Individual
JOE HOLLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 S UTAH AVE, IDAHO FALLS, ID 83402-3305
(208) 528-8703
Mailing address
4382 E 375 N, RIGBY, ID 83442-5517
(208) 745-0256
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P4233
ID
Other
Enumeration date
08/14/2014
Last updated
08/14/2014
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