Individual
MS. CRYSTAL IDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1300 E PARK AVE, ANACONDA, MT 59711-2729
(406) 563-5266
Mailing address
3002 WYNNE AVE, BUTTE, MT 59701-3340
(406) 560-9893
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12343
MT
Other
Enumeration date
06/19/2013
Last updated
06/19/2013
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