Individual
MALLORY CHAPMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1450 N 2ND E, REXBURG, ID 83440-5131
(208) 359-2814
Mailing address
299 MARGETTE WAY, IDAHO FALLS, ID 83402-2964
(208) 569-3200
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P9192
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P9192
—
ID
Enumeration date
03/04/2021
Last updated
03/04/2021
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