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1013306968
JASON EBRAHIMPOUR
CALDWELL, ID
NPI
1013306968
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: ID P6484)
Enumeration Date
2015-01-15
Last Update Date
2015-01-15
Business Address
-- JASON EBRAHIMPOUR
425 N 10TH AVE
CALDWELL, ID 83605-3402
Phone number: 208-454-1111
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Mailing Address
-- JASON EBRAHIMPOUR
425 N 10TH AVE
CALDWELL, ID 83605-3402
Phone number: 208-454-1111
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