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Individual

DR. WYNNONA SARAH WARREN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
911 NORTH MAIN STREET, POCATELLO, ID 83204
(208) 478-8510
(208) 235-1328
Mailing address
911 NORTH MAIN STREET, POCATELLO, ID 83204
(208) 478-8510
(208) 235-1328

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
8069703-1701
UT
183500000X
Pharmacist
Primary
P6627
ID

Other

Enumeration date
08/13/2012
Last updated
12/13/2016
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