Individual
MARC ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 N STATE ST, RIGBY, ID 83442-1443
(208) 745-0267
Mailing address
150 N STATE ST, RIGBY, ID 83442-1443
(208) 745-0267
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P7318
ID
Other
Enumeration date
09/01/2015
Last updated
09/01/2015
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