Individual
CAROL M CORNELIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD, RPH
Contact information
Practice address
420 S ORCHARD ST, BOISE, ID 83705-1238
(208) 947-0967
(208) 947-0967
Mailing address
420 S ORCHARD ST, BOISE, ID 83705-1238
(208) 947-0967
(208) 947-0967
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
5659
MT
183500000X
Pharmacist
Primary
P6492
ID
Other
Enumeration date
05/12/2011
Last updated
05/12/2011
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