Individual
CODY JAMES MOSEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2490
Mailing address
2020 S LUXURY LN APT D205, MERIDIAN, ID 83642-4310
(505) 363-7107
Taxonomy
Speciality
Code
Description
License number
State
1835P0200X
Pediatric Pharmacist
Primary
8151148
ID
Other
Enumeration date
05/18/2022
Last updated
05/18/2022
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