Individual
JORDAN KELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACY INTERN
Contact information
Practice address
4700 N EAGLE RD, BOISE, ID 83713-0744
(208) 939-5149
(208) 939-5282
Mailing address
7411 E SAXTON LN, NAMPA, ID 83687-9483
(503) 789-8202
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
I50177
ID
Other
Enumeration date
06/27/2019
Last updated
06/27/2019
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