Individual
NOE RONQUILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5425 W CHINDEN BLVD, GARDEN CITY, ID 83714-1468
(208) 323-7036
Mailing address
391 N MIRA AVE, STAR, ID 83669-5423
(208) 284-1806
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9161670
ID
Other
Enumeration date
08/07/2024
Last updated
08/07/2024
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