Individual
KORI ANN WITTROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
465 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 234-4700
(208) 282-4696
Mailing address
465 MEMORIAL DR, POCATELLO, ID 83201-4008
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P7831
ID
Other
Enumeration date
08/01/2017
Last updated
03/17/2018
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