Individual
MR. JOHAN VAN NIEKERK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
715 12TH AVE S, NAMPA, NAMPA, ID 83651-4254
(208) 466-3592
Mailing address
715 12TH AVE S, NAMPA, NAMPA, ID 83651-4254
(208) 466-3592
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6034
ID
Other
Enumeration date
05/05/2008
Last updated
05/05/2008
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