Individual
MISS JEANNE MARIA RUSSOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
731 POLE LINE RD, TWIN FALLS, ID 83301-3036
(208) 736-1725
(208) 736-7318
Mailing address
731 POLE LINE RD, TWIN FALLS, ID 83301-3036
(208) 736-1725
(208) 736-7318
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P4821
ID
Other
Enumeration date
01/26/2012
Last updated
01/26/2012
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