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Individual

JUSTIN DWIGHT GOODRICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
2107 BLAINE ST, CALDWELL, ID 83605-4427
(208) 455-1094
Mailing address
8510 W HILL ROAD PKWY, BOISE, ID 83714-2500
(208) 968-8231

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P10078
ID

Other

Enumeration date
07/08/2022
Last updated
07/08/2022
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