Individual
GRACE ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-4353
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-4353
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8971558
ID
Other
Enumeration date
06/24/2025
Last updated
06/24/2025
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