Individual
BURGUNDIE BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2252 CORONADO ST, IDAHO FALLS, ID 83404-7552
(208) 523-3360
Mailing address
456 SUNFLOWER RD, REXBURG, ID 83440-4921
(208) 220-8231
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
I75864
ID
Other
Enumeration date
01/04/2025
Last updated
01/04/2025
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