Individual
DANIEL SHANE STIMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1850 E FAIRVIEW AVE, MERIDIAN, ID 83642-5702
(208) 887-5273
Mailing address
1850 E FAIRVIEW AVE, MERIDIAN, ID 83642-5702
(208) 887-5273
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6521
ID
Other
Enumeration date
07/05/2012
Last updated
07/05/2012
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