Individual
MANDY PALESANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
9850 W ST LUKES DR, NAMPA, ID 83687-7912
(208) 505-2628
Mailing address
4909 N ELSINORE AVE APT O101, MERIDIAN, ID 83646-6980
(918) 418-0607
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P11010
ID
Other
Enumeration date
12/06/2023
Last updated
12/13/2023
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