Individual
CIARA MINOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
414 N MAIN ST, MOSCOW, ID 83843
(208) 882-6076
(208) 882-6846
Mailing address
411 N MAIN ST, MOSCOW, ID 83843-2630
(509) 760-1322
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6700
ID
183500000X
Pharmacist
PH60658522
WA
Other
Enumeration date
08/27/2015
Last updated
08/26/2018
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