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Individual

TRACY BECKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARM.D.

Contact information

Practice address
235 S 4TH AVE, POCATELLO, ID 83201-6438
(208) 233-3341
Mailing address
CAMPUS BOX 8493, IDAHO STATE UNIVERSITY, POCATELLO, ID 83209
(208) 234-7598

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5679
ID

Other

Enumeration date
01/19/2010
Last updated
01/19/2010
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