Individual
TARA MARIE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2219 12TH AVE RD, NAMPA, ID 83686-6313
(208) 318-0536
Mailing address
2219 12TH AVE RD, NAMPA, ID 83686-6313
(208) 318-0536
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
CT38431
ID
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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