Individual
MRS. BECKY ANN PICKARD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
330 W ASH ST, GENESEE, ID 83832
(208) 285-1162
Mailing address
231 E WALNUT ST, GENESEE, ID 83832-8723
(208) 285-1162
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AT-252
ID
Other
Enumeration date
05/04/2006
Last updated
07/08/2007
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