Individual
SHANNON MARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
660 E BOISE AVE, BOISE, ID 83706-5118
(208) 336-8340
(208) 336-0985
Mailing address
660 E BOISE AVE, BOISE, ID 83706-5118
(208) 336-8340
(208) 336-0985
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5922
ID
183500000X
Pharmacist
RPH-0011571
OR
Other
Enumeration date
06/21/2010
Last updated
06/21/2010
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