Individual
MR. KENT L QUICKSTAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2490
(208) 381-4501
Mailing address
190 EAST BANNOCK, ST LUKES REGIONAL MEDICAL CENTER, BOISE, ID 83712-6241
(208) 381-2490
(208) 381-4501
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P4487
ID
Other
Enumeration date
11/01/2007
Last updated
11/01/2007
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