Individual
SARA SHULTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Mailing address
982 W 4TH N, MOUNTAIN HOME, ID 83647-6325
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
36748
TX
Other
Enumeration date
04/08/2019
Last updated
12/12/2024
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