Individual
DR. CHANINE ANGELINA DEFENSOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1145
Mailing address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1145
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PHA.0022924
CO
Other
Enumeration date
09/26/2019
Last updated
06/20/2023
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