Individual
MRS. MADELINE P ATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
4700 N EAGLE RD, BOISE, ID 83713-0744
(208) 939-5149
(208) 939-5282
Mailing address
1748 N TRAIL CREEK WAY, EAGLE, ID 83616-4098
(208) 939-6897
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5557
ID
Other
Enumeration date
06/20/2011
Last updated
06/20/2011
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