Individual
DR. JEREMY EBRAHIMPOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM. D.
Contact information
Practice address
4364 W AUDUBON PL, BOISE, ID 83705-3852
(208) 709-5793
Mailing address
4364 W AUDUBON PL, BOISE, ID 83705-3852
(208) 709-5793
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6556
ID
Other
Enumeration date
08/21/2012
Last updated
08/21/2012
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