Individual
SHAUN JEFFREY WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
960 W BRIDGE ST, BLACKFOOT, ID 83221-1912
(208) 785-8000
(208) 785-9624
Mailing address
960 W BRIDGE ST, BLACKFOOT, ID 83221-1912
(208) 785-8000
(208) 785-9624
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5998
ID
Other
Enumeration date
09/13/2007
Last updated
09/13/2007
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