Individual
TARMIGAN CUSHING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 S 25TH E, AMMON, ID 83406-5729
(208) 522-2866
Mailing address
1201 S 25TH E, AMMON, ID 83406-5729
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5114
ID
Other
Enumeration date
08/18/2014
Last updated
08/18/2014
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