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Individual

MR. JACK ARTHUR HELGESON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
405 S MAIN ST, PAYETTE, ID 83661-3317
(208) 642-9331
(208) 642-1550
Mailing address
405 S 8TH ST, PAYETTE, ID 83661
(208) 642-9331
(208) 642-1550

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5317
ID
183500000X
Pharmacist
PH00009915
WA
183500000X
Pharmacist
RPH0008024
OR

Other

Enumeration date
07/06/2011
Last updated
07/06/2011
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