Individual
KAREN D LODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
5211 S FARMHOUSE PL, BOISE, ID 83716
(208) 724-9338
Mailing address
5211 S FARMHOUSE PL, BOISE, ID 83716-9014
(208) 724-9338
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5386
ID
Other
Enumeration date
06/27/2012
Last updated
06/27/2012
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