Search › Idaho › 183500000X
John Willis
NPI 1619393493 · on the registry since 2014
Practice
- Address
- 6452 Main St
Bonners Ferry, ID 83805 - Phone
- (208) 267-4021
- Fax
- (208) 267-4024
- Organisation at this address
- Medicine Man Bonners Ferry Pharmacy Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 183500000X
183500000X
- Licence states on file
- MT
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-05-25
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho