Individual
ISAAC MCCONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2107 BLAINE ST, CALDWELL, ID 83605
(208) 455-1094
(208) 455-1097
Mailing address
2107 BLAINE ST, CALDWELL, ID 83605-4427
(208) 455-1094
(208) 455-1097
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
T2300
ID
183700000X
Pharmacy Technician
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Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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