Individual
TRACY MICHELLE COFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1023 YELLOWSTONE AVE STE J, POCATELLO, ID 83201-4478
(208) 233-2444
(208) 912-0950
Mailing address
1023 YELLOWSTONE AVE STE J, POCATELLO, ID 83201-4478
(208) 233-2444
(208) 912-0950
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
P5360
ID
Other
Enumeration date
01/22/2020
Last updated
01/22/2020
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