Individual
DR. MICHAEL BRUNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
450 E MAIN ST, REXBURG, ID 83440-2048
(208) 359-6900
Mailing address
4320 GREENWILLOW LN, IDAHO FALLS, ID 83401-3736
(208) 201-6281
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4861268
ID
Other
Enumeration date
07/17/2024
Last updated
07/17/2024
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