Matthew Bolen

NPI #1114735818 in Star, Idaho

Provider Information

NPI Number: 1114735818
Entity Type: Individual
Name: Matthew Bolen
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Dec 27, 2024
Last Updated: Dec 27, 2024

Practice Location

Address: 145 S PLUMMER RD
City: Star
State: Idaho
ZIP Code: 83669-6199
Phone: (208) 286-0906

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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