Individual
MRS. CAROL BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
436 E BONNEVILLE ST, POCATELLO, ID 83201-6406
(208) 233-3466
(208) 235-7296
Mailing address
436 E BONNEVILLE ST, POCATELLO, ID 83201-6406
(208) 233-3466
(208) 235-7296
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5572
ID
Other
Enumeration date
09/09/2008
Last updated
09/09/2008
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