Individual
MS. TINA U BANDEKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10530 W CARLTON BAY DR, GARDEN CITY, ID 83714-5111
(208) 319-2482
(208) 319-2488
Mailing address
5852 N ROTHMANS AVE, BOISE, ID 83713-0927
(208) 794-8755
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6058
ID
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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