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Individual

DR. JASON MICHAEL BAILEY

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PHARM.D

Contact information

Practice address
1441 PARKWAY DR, BLACKFOOT, ID 83221-1667
(208) 785-2600
Mailing address
4955 ROSE ST, CHUBBUCK, ID 83202-2269
(208) 237-3053

Taxonomy

Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
P5754
ID

Other

Enumeration date
08/19/2005
Last updated
07/08/2007
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