Individual
JULIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMACIST
Contact information
Practice address
1901 S 25TH E, AMMON, ID 83406-5710
(208) 524-1616
Mailing address
1901 S 25TH E, AMMON, ID 83406-5710
(208) 524-1616
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P8746
ID
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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