Individual
DILLON TUAN THAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2490
Mailing address
9824 W ROSECROFT CT UNIT 103, BOISE, ID 83704-5080
(209) 244-6714
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P10053
ID
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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