Individual
TIMOTHY ELRAY ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
570 S STATE ST, SHELLEY, ID 83274-1470
(208) 357-0473
(208) 357-0498
Mailing address
570 S STATE ST, SHELLEY, ID 83274-1470
(208) 357-0473
(208) 357-0498
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5170
ID
Other
Enumeration date
08/11/2012
Last updated
08/11/2012
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