Individual
JANET MAYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
1611 BLUE LAKES BLVD N, TWIN FALLS, ID 83301-3374
(208) 736-3321
Mailing address
1765 E 4500 N, BUHL, ID 83316-5306
(208) 308-0850
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5748
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P5748
STATE LICENSE
ID
Enumeration date
08/17/2016
Last updated
08/17/2016
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