Individual
CHARLES POTTENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
523 THAIN RD, LEWISTON, ID 83501-5530
(208) 743-5515
Mailing address
523 THAIN RD, LEWISTON, ID 83501-5530
(208) 743-5515
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P7070
ID
Other
Enumeration date
07/10/2014
Last updated
01/09/2015
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