Individual
CHRISTINE LUU PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
235 S 4TH AVE, POCATELLO, ID 83201-6438
(208) 233-3341
Mailing address
4170 HAWTHORNE RD APT A202, POCATELLO, ID 83202-2710
(949) 683-8823
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P9479
ID
Other
Enumeration date
07/21/2021
Last updated
07/21/2021
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