Individual
JORDAN ELWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
1653 S VISTA AVE, BOISE, ID 83705
(208) 331-3007
Mailing address
1653 S VISTA AVE, BOISE, ID 83705-3172
(253) 304-7994
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P10068
ID
Other
Enumeration date
07/02/2019
Last updated
01/12/2023
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