Individual
JULIE EISELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
1348 W STAFFORD DR, EAGLE, ID 83616-6487
(208) 939-8533
Mailing address
1348 W STAFFORD DR, EAGLE, ID 83616-6487
(208) 939-8533
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5790
ID
Other
Enumeration date
08/17/2007
Last updated
08/17/2007
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