Individual
DR. JESUS ENRIQUE GONZALEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
8100 W FAIRVIEW AVE, BOISE, ID 83704-8425
(208) 375-2825
Mailing address
411 SUNSET CT APT 303, CALDWELL, ID 83605-0414
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P9515
ID
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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