Individual
JASON LORENZO PALACIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(208) 381-2711
Mailing address
657 N FINSBURY WAY, STAR, ID 83669-5569
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P10862
ID
Other
Enumeration date
01/04/2024
Last updated
01/04/2024
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