Individual
VENETTA JEAN CHRISTOPHERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD, CGP
Contact information
Practice address
436 E BONNEVILLE, POCATELLO, ID 83201
(208) 233-3466
(208) 234-9686
Mailing address
5480 COUNTRY CLUB DR, POCATELLO, ID 83204-4681
(208) 233-1464
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
P5129
ID
Other
Enumeration date
12/18/2006
Last updated
07/08/2007
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