Individual
KIM JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
10530 W CARLTON BAY DR, GARDEN CITY, ID 83714-5111
(208) 319-2482
Mailing address
10530 W CARLTON BAY DR, GARDEN CITY, ID 83714-5111
(208) 319-2482
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6716
ID
Other
Enumeration date
04/18/2013
Last updated
04/18/2013
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