Individual
TRAVIS FRAKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
801 POLE LINE RD W, TWIN FALLS, ID 83301-5810
(208) 814-2500
Mailing address
801 POLE LINE RD W, TWIN FALLS, ID 83301-5810
(208) 814-2500
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P10227
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P10227
IDAHO STATE BOARD OF PHARMACY
ID
Enumeration date
08/19/2022
Last updated
08/19/2022
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