Individual
DR. TYSON C SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
305 W QUINN RD, POCATELLO, ID 83201-4988
(208) 238-4049
(208) 238-4046
Mailing address
305 W QUINN RD, POCATELLO, ID 83201-4988
(208) 238-4049
(208) 238-4046
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6120
ID
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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