Individual
ANGELINA THAO NGUYEN DO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
164 E MAIN ST, REXBURG, ID 83440-1912
(208) 227-5076
Mailing address
567 COUNTRYSIDE AVE, REXBURG, ID 83440-5338
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P9002
ID
Other
Enumeration date
11/11/2020
Last updated
11/11/2020
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