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Individual

MR. GARY KEVIN PULLEN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
2250 CORONADO ST, IDAHO FALLS, ID 83404-7552
(208) 528-7979
(208) 512-2238
Mailing address
2250 CORONADO ST, IDAHO FALLS, ID 83404-7552
(208) 528-7979
(208) 512-2238

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
P4336
ID
1835P1200X
Pharmacotherapy Pharmacist
Primary
P4336
ID

Other

Enumeration date
08/24/2005
Last updated
09/11/2025
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