Individual
JASON DAVID DALLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1600 N MAIN ST, MERIDIAN, ID 83642-1709
(208) 888-7311
(208) 887-3446
Mailing address
11709 W ROCKHAMPTON ST, BOISE, ID 83709-4478
(208) 377-3707
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5997
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P5997
IDAHO STATE BOARD OF PHARMACY LICENSE
ID
Enumeration date
11/18/2008
Last updated
01/01/2009
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