Individual
MR. TODD S DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.SC.
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2490
Mailing address
5046 W PARSONS DR, BOISE, ID 83714-9467
(208) 229-3844
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P4918
ID
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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