Individual
DANIEL JOSEPH BOUTWELL SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
650 MANGROVE AVE, CHICO, CA 95926-3947
Mailing address
650 MANGROVE AVE, CHICO, CA 95926-3947
(530) 891-6722
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
1080752
CA
Other
Enumeration date
07/19/2021
Last updated
07/19/2021
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