Individual
DALYS DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
411 N MAIN ST, MOSCOW, ID 83843-2630
(208) 882-0900
Mailing address
411 N MAIN ST, MOSCOW, ID 83843-2630
(208) 882-0900
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P10853
ID
Other
Enumeration date
08/22/2023
Last updated
08/22/2023
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