JORDAN MATTHEW LIST

BOISE, ID
NPI1225268345
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: KS  1-14481)
Enumeration Date2009-07-23
Last Update Date2009-07-23
Business Address
-- JORDAN MATTHEW LIST Pharm.D.
VA MEDICAL CENTER 500 W FORT STREET (119)
BOISE, ID 83702-4598
Phone number: 208-422-1000
Mailing Address
-- JORDAN MATTHEW LIST Pharm.D.
5645 S DAFFODIL PL
BOISE, ID 83716-6952
Phone number: 785-550-3724
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