Individual
ERIC VERN HERZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
705 BLUE LAKES BLVD N, TWIN FALLS, ID 83301-4007
(208) 736-5373
Mailing address
705 BLUE LAKES BLVD N, TWIN FALLS, ID 83301-4007
(208) 736-5373
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5550
ID
Other
Enumeration date
03/01/2012
Last updated
03/01/2012
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