Individual
MADISON BALLIF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1600 N MAIN ST, MERIDIAN, ID 83642-1709
(208) 888-7311
Mailing address
1428 MITCHELL DR, OGDEN, UT 84403-1324
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P10161
ID
Other
Enumeration date
08/07/2022
Last updated
08/07/2022
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