Individual
MIREN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
509 E PARKCENTER BLVD, APT 210, BOISE, ID 83706-6684
(208) 999-2900
Mailing address
509 E PARKCENTER BLVD, APT. 210, BOISE, ID 83706-6684
(208) 999-2900
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202209403
VA
183500000X
Pharmacist
Primary
P7706
ID
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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