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Individual

SCOTT C. JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD,

Contact information

Practice address
1295 PARKWAY DR, BLACKFOOT, ID 83221-1683
(208) 785-1311
Mailing address
129 E 600 N, BLACKFOOT, ID 83221-5772
(208) 604-4238

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6540
ID

Other

Enumeration date
04/29/2013
Last updated
04/29/2013
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