Individual
BRIDGETTE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
535 E 17TH ST, IDAHO FALLS, ID 83404-6154
(208) 542-4569
Mailing address
535 E 17TH ST, IDAHO FALLS, ID 83404-6154
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P8416
ID
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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