Individual
SAGE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
305 W QUINN RD, POCATELLO, ID 83201-4988
(208) 238-4049
Mailing address
98 POPLAR ST, BLACKFOOT, ID 83221-1799
(208) 785-4100
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2961973
ID
Other
Enumeration date
12/12/2024
Last updated
12/12/2024
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