Individual
MR. CHARLES M DAVIS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2530 MARILYN ST, POCATELLO, ID 83201-8022
(208) 237-6993
Mailing address
2530 MARILYN ST, POCATELLO, ID 83201-8022
(208) 237-6993
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P-4701
ID
Other
Enumeration date
05/22/2008
Last updated
05/22/2008
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