Individual
KIM MCCLUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
235 S 4TH AVE, POCATELLO, ID 83201-6438
(208) 233-3341
Mailing address
14516 W LACEY RD, POCATELLO, ID 83202-5017
(208) 241-8785
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P4788
ID
Other
Enumeration date
09/16/2013
Last updated
01/16/2014
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