Individual
JASON MITCHELL HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1855 W BROADWAY ST, IDAHO FALLS, ID 83402-3043
(208) 529-3638
Mailing address
1855 W BROADWAY ST, IDAHO FALLS, ID 83402-3043
(208) 529-3638
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P8052
ID
Other
Enumeration date
07/23/2018
Last updated
11/01/2023
About Stedi
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