Individual
DR. C. DUSTIN WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-3436
Mailing address
10042 W GARVERDALE DR APT 102, BOISE, ID 83704-8026
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
P6019
ID
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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