Individual
DR. JACOB COTTAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3475 E 17TH ST, AMMON, ID 83406-6781
(208) 227-5083
(208) 227-5087
Mailing address
3475 E 17TH ST, AMMON, ID 83406-6781
(208) 227-5083
(208) 227-5087
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6691
ID
Other
Enumeration date
08/15/2012
Last updated
08/15/2012
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