Individual
MARK DAVID JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1683 E MYRTLE BEACH CT, EAGLE, ID 83616-5366
(208) 985-3271
Mailing address
1683 E MYRTLE BEACH CT, EAGLE, ID 83616-5366
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5795
ID
Other
Enumeration date
02/18/2020
Last updated
02/18/2020
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