Individual
BRECON POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2460 PROSPECT DR, IDAHO FALLS, ID 83401-5078
(307) 248-1627
Mailing address
2460 PROSPECT DR, IDAHO FALLS, ID 83401-5078
(307) 248-1627
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P7084
ID
Other
Enumeration date
09/11/2014
Last updated
09/11/2014
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