Individual
RUSSELL FOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3395 S FEDERAL WAY, BOISE, ID 83705-5217
(208) 319-1043
Mailing address
2119 S DENVER AVE, BOISE, ID 83706-4501
(208) 599-4285
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P7157
ID
Other
Enumeration date
03/11/2015
Last updated
03/11/2015
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