Individual
MAIA CASTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(208) 381-3108
Mailing address
11922 W FAIRVIEW AVE APT E208, BOISE, ID 83713-7921
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P11261
ID
Other
Enumeration date
07/17/2024
Last updated
07/17/2024
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