Individual
KELLY JONE LIERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMACY TECHNICIAN
Contact information
Practice address
8100 W FAIRVIEW AVE, BOISE, ID 83704-8425
(208) 375-2825
Mailing address
8100 W FAIRVIEW AVE, BOISE, ID 83704-8425
(208) 375-2825
(208) 375-2846
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
CT37894
ID
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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