Individual
JOHN WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6452 MAIN ST, BONNERS FERRY, ID 83805-8520
(208) 267-4021
(208) 267-4024
Mailing address
6452 MAIN ST, BONNERS FERRY, ID 83805-8520
(208) 267-4021
(208) 267-4024
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12477
MT
Other
Enumeration date
03/17/2014
Last updated
05/25/2022
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