Individual
EMILY MICHELLE BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Mailing address
3502 E GRAND FOREST DR APT 104, BOISE, ID 83716-5854
(904) 412-8034
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P8961
ID
Other
Enumeration date
07/30/2020
Last updated
07/30/2020
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